Operative management of bilateral facet dislocation

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Abstract
✓ Fifty-two patients with acute traumatic bilateral locked facets were treated at one trauma center during a 3½-year period (July, 1987, to December, 1990). The patients presented with complete motor quadriplegia (34 cases), incomplete myelopathy (13 cases), or intact long-tract function (five cases). The injuries occurred at C2–3 (one patient, with intact function), C4–5 (12 patients), C5–6 (16 patients), C6–7 (19 patients), and C7—T1 (four patients). Immediate traction (with increasing weight and serial x-ray studies) and/or induction of general anesthesia and muscle relaxation reduced the dislocation in 40 patients, but 12 needed prompt operative reduction as their injuries failed to reduce within 4 hours. Stabilization was indicated for all patients, but three did not undergo surgery: two elderly patients with complete injuries (one refused surgery and one died), and one patient with multiple injuries (fusion was achieved by halo-vest immobilization for 3 months). Of the 49 patients treated operativel...