Lower Cervical Spine Fractures and Dislocations - Unilateral Facet Fracture Dislocation

Lower Cervical Spine Fractures and Dislocations

EXAMPLE 2

UNILATERAL CERVICAL FACET FRACTURE DISLOCATION

DIAGNOSIS:

Left C6/7 unilateral facet fracture dislocation with fracture of left C7 lateral mass

Preexisting cervical spondylosis

Already dessicated C6/7 intervertebral disc

No significant disc fragment or prolapse

Left C7 radiculopathy from compressed nerve root in neural foramen

Cervical central canal mild stenosis but cervical spinal cord not compressed

OPTIONS:

Reduction method

Need for decompression?

Fixation method

PROCEDURE:

Posterior Approach for decompression, instrumentation and fusion

Open Reduction

Cervical Pedicle Screw C6 C7

CPS has 3x pull out strength of lateral mass screw

Achieve 3 column (ie anterior stability)

Foraminotomy left C6-7

Excision fracture of lateral mass C7

PROGRESS:

Rotatory neck deformity corrected

Numbness and arm pain resolved

Female mid forties

Skiing injury early February 2008

Main complaint of severe left sided neck pain and stiffness, right ankle fracture

Examination

left index and middle finger numbness

weak left triceps

right ankle fracture

Transferred to Hong Kong 3 weeks after injury

Example 3

Bilateral Cervical Facet Fracture Dislocation

C6-7 Fracture Dislocation

MRI - Cord Not Compressed

3D CT Reconstruction

SPINE CARE HONG KONG

ACCURATE DIAGNOSIS, STRUCTURED TREATMENT