Abstract
Objective. To discuss the clinical efficacy of manual close reduction in emergency room and different surgery choices in treating traumatic subaxial cervical facet dislocation patients.
Summary of Background Data. The treatment of traumatic subxial cervical facet dislocation is controversial. Although there are heterogeneous methods, it is challenge for surgeons to make a proper surgery choice to treat the traumatic subxial cervical facet dislocation.
Methods. A retrospective study was performed on 10 case of traumatic subaxial cervical facet dislocation treated by manual close reduction and different surgery procedures from January 2019 to January 2023. There were 8 males, 2 females, with a meal age of 52.7 years (from 32 to 80 yr). Dislocation sites: 2 in C6-7, 5 in C5-6
, 3 in C4-5; 2 cases with unilateral cervical facet dislocation, 8 cases with bilateral dislocation.
Results. All the patients were performed manually close reduction in emergency room as soon as the dislocation diagnosis was made. 5 patients achieved successful manual close reduction. 2 patients achieved successful close reduction through cranial traction. 7 patients undertook anterior approach, or anterior-posterior approach or posterior-anterior approach surgeries and 5 patients were
postoperatively classified as grade E according to Frankel
standard. All patients were followed up for average of 6 months.
Conclusion. Manual close reduction in emergency room may be a good choice for traumatic subaxial cervical facet dislocation patients, if failed, cranial traction may be useful for close reduction. Emergency open reduction, neurological decompression and internal fixation should be performed if close reduction is fail. Different surgical procedures choice should base on the patent’s neurological status and the surgeon’s experience.