Management of Unilateral Cervical Facet Joint Dislocation in Neurologically Intact Patients: Results of an Ao Spine latin American Survey

Joaquim, Andrei Fernandes; Yurac, Ratko; Valacco, Marcelo; Neto, Orlando Righesso; Carazzo, Charles André; Cabrera, Juan P.; Teles, Alisson Roberto; Sfreddo, Ericson; Falavigna, Asdrúbal

doi:10.1016/j.wneu.2020.10.011

Cited by 7 publications

(3 citation statements)

References 22 publications

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Section: Discussionmentioning

confidence: 99%

“…In this region, there are significant differences in the treatment of unilateral cervical facet joint dislocation: 65% of the spine surgeons studied considered it mandatory to have an MRI before treatment. 11 Here, we analyzed the 3 most common complementary studies ordered by spine surgeons after a documented facet fracture in the CT scan. Most surgeons requested an additional exam after a CT; the crescent prevalence confirmed the degree of severity ranging from 72.5% in F1 to 96.1% in F4.…”

Section: Discussionmentioning

confidence: 99%

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CT Scan in Subaxial Cervical Facet Injury: Is It Enough for Decision-Making?

Cabrera

Yurac

Joaquim

et al. 2021

Global Spine Journal

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Study Design: Cross-sectional survey. Objectives: Assessment of subaxial cervical facet injuries using the AO Spine Subaxial Cervical Spine Injury Classification System is based on CT scan findings. However, additional radiological evaluations are not directly considered. The aim of this study is to determine situations in which spine surgeons request additional radiological exams after a facet fracture. Methods: A survey was sent to AO Spine members from Latin America. The evaluation considered demographic variables, routine use of the Classification, as well as the timepoint at which surgeons requested a cervical MRI, a vascular study, and/ or dynamic radiographs before treatment of facet fractures. Results: There was 229 participants, mean age 42.9 ± 10.2 years; 93.4% were men. Orthopedic surgeons 57.6% with 10.7 ± 8.7 years of experience in spine surgery. A total of 86% used the Classification in daily practice. An additional study (MRI/vascular study/and dynamic radiographs) was requested in 53.3%/9.6%/43.7% in F1 facet injuries; 76.0%/20.1%/50.2% in F2; 89.1%/65.1%/28.4% in F3; and 94.8%/66.4%/16.6% in F4. An additional study was frequently required: F1 72.5%, F2 86.9%, F3 94.7%, and F4 96.1%. Conclusions: Spine surgeons generally requested additional radiological evaluations in facet injuries, and MRI was the most common. Dynamic radiographs had a higher prevalence for F1/F2 fractures; vascular studies were more common for F3/F4 especially among surgeons with fewer years of experience. Private hospitals had a lower spine trauma cases/year and requested more MRI and more dynamic radiographs in F1/F2. Neurosurgeons had more vascular studies and dynamic radiographs than orthopedic surgeons in all facet fractures.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

CT Scan in Subaxial Cervical Facet Injury: Is It Enough for Decision-Making?

Cabrera

Yurac

Joaquim

et al. 2021

Global Spine Journal

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“…However, in locations where acquiring MRI will substantially delay a closed reduction, the reduction may occur prior to MRI. If a patient sustains an incomplete spinal cord injury and there is a delay in acquiring MRI, urgent reduction is warranted prior to MRI if the patient can cooperate with the physical examination 25,26 . In obtunded or uncooperative patients who cannot comply with a spine examination, MRI is mandatory prior to an attempted closed reduction or stabilization due to the risk of further cord compression or neurologic injury from displacement of a traumatic disc herniation 27 .…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Traumatic Cervical Facet Fractures and Dislocations

et al. 2022

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Flexion-distraction, axial loading, and rotational forces can cause various degrees of osseoligamentous disruption of the cervical spine, leading to traumatic cervical facet fractures and dislocations.Low-energy forces lead to minimally displaced facet fractures that often can be treated with immobilization only. High-energy forces are more likely to cause unstable injuries with or without neurologic compromise, which may require surgical intervention.The initial treatment of cervical facet injuries requires patient evaluation and management through the Advanced Trauma Life Support (ATLS) protocols, while definitive management varies based on the biomechanical components of the injury, the neurologic status of the patient, and additional patient factors.Cervical facet injuries often require a multidisciplinary approach to optimize long-term functional outcomes and minimize serious complications.

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Activity and sports resumption after long segment fusions to the pelvis for adult spinal deformity: survey results of AO Spine members

et al. 2023

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Purpose To assess recommendations for when adult spinal deformity (ASD) patients may return to athletic activities after surgery. Methods A web-based survey was administered to members of AO Spine. The survey consisted of surgeon demographic information and questions asking when a patient undergoing a long thoracolumbar fusion (> 5 levels) with pelvic fixation for ASD would be allowed to resume unrestricted range of motion (ROM), non-contact sports, and contact sports postoperatively. Ordinal logistic regression was used to determine predictors for time to resume each activity. Results One hundred twenty four members’ responses were included for analysis. The majority of respondents would allow unrestricted ROM within 3 months postop (< 3 months: 81% vs > 3 months: 19%]. For when to return to non-contact sports, the most common responses were “2–3 months” (26.6%), “3–4 months” (26.6%), and “6–12 months” (18.5%). For when to return to contact sports, the majority advised > 4 months postop [> 4 months: “4–6 months” (19.2%), “6–12 months” (28.0%), “ > 12 months” (28.8%) versus < 4 months: “1–2 months” (4.0%), “2–3 months” (1.6%), “3–4 months” (8.8%)]. 8.8% responded they would “never” allow resumption of contact sports. Conclusion There was significant variation between surgeons’ recommendations for resumption of unrestricted range of motion and sports following long fusion with pelvic fixation for ASD. An evidence-based approach to activity recommendations will require information on outcomes and complications.

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Management of Unilateral Cervical Facet Joint Dislocation in Neurologically Intact Patients: Results of an Ao Spine latin American Survey

Cited by 7 publications

References 22 publications

CT Scan in Subaxial Cervical Facet Injury: Is It Enough for Decision-Making?

CT Scan in Subaxial Cervical Facet Injury: Is It Enough for Decision-Making?

Traumatic Cervical Facet Fractures and Dislocations

Activity and sports resumption after long segment fusions to the pelvis for adult spinal deformity: survey results of AO Spine members

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