Cervical facet dislocation

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Background

Clinical Features

Diagnosis

Differential Diagnosis

Vertebral fractures and dislocations types

Vertebral anatomy.

Workup

Management

Prehospital Immobilization

See NAEMSP National Guidelines for Spinal Immobilization

Hospital

  • C-collar
  • Consult ortho or spine as needed

Disposition

  • Admit

See Also

Cervical facet dislocation

  • determine if more than 1 spinal column affected
    • 1 column = generally stable
    • 2 or more columns = unstable
  • generally superior facet fx
  • abnormal xray? -> get CT

Bilateral

  • Unstable as whole column can sublux
  • high risk for significant spinal cord injury
  • Disruption of annulus fibrosus and ant longitudinal ligament > ant displacement of spine
  • Imaging
    • Lateral xray: vertebral body will be displaced ~50% of its width
  • Management
    • spinal precautions
    • operative management: nsg vs ortho

Unilateral

  • Relatively Stable
  • Presentation
    • C5/C6: C6 radiculopathy with weakness to wrist extension numbness and tingling in the thumb
    • C6/C7: C7 radiculopathy with weakness to triceps and wrist flexion and numbness in index and middle finger
  • Imaging
    • Lateral x-ray: vertebral body will be displaced ~25% of its width
    • Anterior x-ray: affected spinous process points toward side that is dislocated
  • Spinal cord injury rarely occurs