Immediate Quadriparesis after Manipulation for Bilateral Cervical Facet Subluxation. A Case Report*

Ludwig, Steven C.; Vaccaro, Alexander R.; Balderston, Richard A.; Cotler, Jerome M.

doi:10.2106/00004623-199704000-00017

Cited by 20 publications

(9 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2,7,8,13,20,21 Ensuring tight, 100% apposition of the facets, a trapezoidal interbody graft, and contouring of the plate into lordosis will optimize the stability of this anterior approach for what is primarily a posterior ligamentous injury. 47 Specific to bilateral facet subluxations, however, are the findings of a study by Elgafy et al, 17 wherein patients with bilateral facet subluxations (perched facets without fracture) were found to develop higher degrees of kyphosis after posterior instrumented fusion. 16,41 When the disc is essentially intact or merely disrupted without frank herniation, then the surgeon can make a choice either anterior or posterior fixation based on patient and surgeon preference.…”

Section: Distraction Injuriesmentioning

confidence: 99%

The Surgical Approach to Subaxial Cervical Spine Injuries

Dvorak

Fisher²,

Fehlings³

et al. 2007

Spine

Self Cite

181

View full text Add to dashboard Cite

show abstract

Section: Distraction Injuriesmentioning

confidence: 99%

The Surgical Approach to Subaxial Cervical Spine Injuries

Dvorak

Fisher²,

Fehlings³

et al. 2007

Spine

Self Cite

181

View full text Add to dashboard Cite

show abstract

“…3 Other complications of closed reduction include overdistraction with stretch injury to the cord 4 and even vertebral artery injury with cerebellar infarction. Additional benefits include the ability to perform moment-to-moment neurologic evaluation during reduction, which, for obvious reasons, cannot be done during open surgical reductions under anesthesia, and the ability to determine if the cord can tolerate the reduced state.…”

Section: Discussionmentioning

confidence: 99%

Infolding of the Ligamentum Flavum

Rhee

Kimmerly

Smucker

2006

Journal of Spinal Disorders &Amp; Techniques

View full text Add to dashboard Cite

Controversy exists regarding management of cervical facet injuries. Previous literature has focused on associated disc herniations reported to cause neurologic injury upon reduction. Although rupture of the ligamentum flavum has been noted with these injuries, its clinical significance has not been examined. In this case report, we present two patients in whom neurologic deterioration occurred due to infolding of the torn ligamentum flavum with spinal cord compression after reduction of cervical facet subluxations. Both had large flaps of ligamentum flavum arising from the caudal lamina which infolded upon reduction and became trapped between the spinal cord and cephalad lamina. Both patients regained normal motor function after removal of the pathologically infolded ligamentum. Neither patient had a disc herniation, hypotensive/anemic/hypoxic event, or epidural hematoma that could have otherwise been causative of the neurologic deficit. Pathologic infolding of ligamentum flavum, in addition to extruded disc herniations, should be recognized as another potential cause for spinal cord compression with reduction of cervical facet injuries. In particular, if there is a long flap of flavum arising from the caudal lamina poised to become entrapped in the spinal canal with reduction and the patient has a congenitally narrow canal, the surgeon should consider removal of the ligamentum flavum prior to reduction.

show abstract

“…The inability of halo fixation to maintain reduction of bilateral facet dislocations has been previously well demonstrated. 1 In most cases, some form of surgical stabilization is performed. Various surgical approaches can be used.…”

Section: Understanding the Management Optionsmentioning

confidence: 99%

18 Unilateral and Bilateral Facet Dislocations

Albert¹,

Lee²,

Lim³

2008

Cervical Spine Surgery Challenges

View full text Add to dashboard Cite

A 34-year-old woman presented with neck pain after a head-on collision. She had no other associated injuries but presented to the emergency department in a cervical collar. Physical examination demonstrated that she was neurologically intact to motor, sensory, and reflex examination. Perianal sensation and rectal tone were normal. She was awake, alert, and cooperative with the examination but appeared to be holding her head slightly rotated toward the right side.

show abstract

Immediate Quadriparesis after Manipulation for Bilateral Cervical Facet Subluxation. A Case Report*

Cited by 20 publications

References 15 publications

The Surgical Approach to Subaxial Cervical Spine Injuries

The Surgical Approach to Subaxial Cervical Spine Injuries

Infolding of the Ligamentum Flavum

18 Unilateral and Bilateral Facet Dislocations

Contact Info

Product

Resources

About