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European Spine Journal

, Volume 21, Issue 2, pp 282–288 | Cite as

Fracture and contralateral dislocation of the twin facet joints of the lower cervical spine

  • Ly Minh Ngo
  • Toshimi AizawaEmail author
  • Takeshi Hoshikawa
  • Yasuhisa Tanaka
  • Tetsuro Sato
  • Yushin Ishii
  • Shoichi Kokubun
Original Article

Abstract

Purpose

The combination of a facet fracture and a contralateral facet dislocation at the same intervertebral level of the cervical spine (a fracture and contralateral dislocation of the twin facet joints) has not been described in detail. The aims of this study are to report a series of 11 patients with this injury, to clarify the clinical features and to discuss its pathomechanism.

Methods

Among 251 patients with lower cervical spine fractures and/or dislocations surgically treated, 11 (9 males and 2 females, averaged age, 52 years) had this kind of injury. Medical charts and medical images were reviewed retrospectively.

Results

Injury levels were C4-5, C5-6 and C6-7 in 1, 4 and 6 patients, respectively. A fracture was found at the superior facet in 6, and at the inferior facet in 5. The anterior displacement of the vertebral body ranged from 7 to 19 mm. The unilateral horizontal facet appearance on an anteroposterior radiograph and the triple image on a CT composed of a separated fracture fragment, the base of the fractured facet, and the neighboring non-fractured facet were characteristic. All patients had neurological deficits from Frankel A to D, and were surgically treated by posterior fusion using wire or cable, or combined anterior and posterior spinal fusion.

Conclusions

The fracture and contralateral dislocation of the twin facet joints can cause severe neurological deficits because of its gross anterior displacement. Its plausible pathomechanism is extension force exerted to the cervical spine when it is maximally bent laterally.

Keywords

Cervical spine Facet fracture Facet dislocation Distractive flexion injury Compressive extension injury Neurological deficits 

Notes

Conflict of interest

No financial and no nonfinancial conflict of interest.

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Ly Minh Ngo
    • 1
  • Toshimi Aizawa
    • 1
    Email author
  • Takeshi Hoshikawa
    • 2
  • Yasuhisa Tanaka
    • 2
  • Tetsuro Sato
    • 3
  • Yushin Ishii
    • 4
  • Shoichi Kokubun
    • 1
  1. 1.Department of Orthopaedic SurgeryTohoku University School of MedicineSendaiJapan
  2. 2.Department of Orthopaedic SurgeryTohoku Central HospitalYamagataJapan
  3. 3.Department of Orthopaedic SurgerySendai Orthopaedic HospitalSendaiJapan
  4. 4.Department of Orthopaedic SurgeryNishitaga National HospitalSendaiJapan

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