Der Orthopäde

, Volume 47, Issue 3, pp 212–220 | Cite as

New reduction technique for the treatment of unilateral locked facet joints of the lower cervical spine

A retrospective analysis of 12 cases
  • Xinjia Wang
  • Guanfeng Yao
  • Yuchun Chen
  • Weidong Wang
  • Jican Zeng



Closed reduction of bilateral locked facet joints of the lower cervical spine is possible, but reduction of unilateral locked facet joints of the lower cervical spine (ULFJLCS) is challenging. We explored a new, simple, safe, and effective closed reduction method for the treatment of ULFJLCS.


A retrospective analysis was done on 12 consecutive cases with traumatic ULFJLCS that underwent closed reduction by Z‑shape elevating-pulling reduction through a halo-vest. After reduction, only anterior cervical decompression and internal fixation were performed. The success of reduction and nerve function was assessed, and follow-up data analyzed.


All patients using our new reduction technique underwent successful closed reduction; the shortest time of reduction was 40 min and the longest 110 (mean, 65) min. No aggravation of neurological damage was observed, nor were other complications. All patients were followed-up from 28 to 72 (mean, 44) months after surgery. The improvement in Frankel’s score (on average) was two levels in most patients.


These data demonstrate that our new reduction technique is a simple, safe, and effective treatment for ULFJLCS.


Locked facet joints Lower cervical spine Unilateral Closed reduction Technique 



One-way analysis of variance


Computed tomography


Diffuse idiopathic skeletal hyperostosis


Magnetic resonance imaging


Ossification of the posterior longitudinal ligament


Unilateral locked facet joints of the lower cervical spine

Neue Repositionstechnik bei unilateral verhakten Facettengelenken der unteren Halswirbelsäule

Eine retrospektive Analyse von 12 Fällen



Die geschlossene Reposition bilateral verhakter Facettengelenke im unteren HWS-Bereich (HWS: Halswirbelsäule) ist möglich. Die Reposition unilateral verhakter Facettengelenke jedoch ist schwierig. Wir untersuchten eine neue, einfache, sichere und effektive geschlossene Repositionsmethode zur Versorgung dieser Verletzungen.


Retrospektiv analysiert wurden 12 konsekutive Fälle mit nach traumatischer Verletzung unilateral verhaktem Facettengelenk im unteren HWS-Bereich, die einer geschlossenen Reposition durch Zug mittels Halo-Weste mit anschließender anteriorer zervikaler Dekompression und internaler Fixierung unterzogen worden waren. Das Gelingen der Reposition und die nervale Funktion wurden überprüft und die Follow-up-Daten analysiert.


Bei allen mit diesem neuen Verfahren behandelten Patienten war die geschlossene Reposition erfolgreich. Die kürzeste hierfür benötigte Zeit betrug 40 min, die längste 110 min (Mittelwert 65 min). Es wurden keine Verschlechterungen der neurologischen Schädigung noch andere Komplikationen beobachtet. Alle Patienten wurden über einen Zeitraum von 28–72 Monaten (Mittelwert 44 Monate) postoperativ nachuntersucht. Die Verbesserung im Frankel-Score betrug bei den meisten Patienten (im Durchschnitt) 2 Grade.


Die vorgestellten Daten zeigen, dass unsere neue Repositionstechnik ein einfaches, sicheres und effektives Verfahren zur Versorgung unilateral verhakter Facettengelenke der unteren HWS darstellt.


Verhakte Facettengelenke Untere Halswirbelsäule Einseitig Geschlossene Reposition Technik 



This work was supported by the Shantou University Medical College Clinical Research Enhancement Initiative (No. 201407) and Shantou City Science and Technology Plan Major Project, Guangdong Province, China (No. 20140305).

Compliance with ethical guidelines

Conflict of interest

X. Wang, G. Yao, Y. Chen, W. Wang and J. Zeng declare that they have no competing interests.

The study protocol was approved by the Ethics Committee of Shantou University Medical College (STUMC; Shantou, China). Written informed consent was obtained from all subjects to be included in the study.


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Copyright information

© Springer Medizin Verlag GmbH 2017

Authors and Affiliations

  • Xinjia Wang
    • 1
  • Guanfeng Yao
    • 1
  • Yuchun Chen
    • 1
  • Weidong Wang
    • 1
  • Jican Zeng
    • 1
  1. 1.Department of Spine Surgery, the Second Affiliated HospitalShantou University Medical CollegeShantouChina

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