Soft tissue injuries associated with traumatic locked facets in the cervical spine

Abstract

The clinical, radiological and operative findings in 10 consecutive patients with cervical spine trauma presenting with locked facets (bilaterally in nine patients) are reported. The treatment was cervical traction until reduction of the locked facets was achieved, followed by anterior surgical decompression and ostheosynthesis. Intervertebral disc herniation was present in nine of the patients, and ruptured calcified posterior longitudinal ligament was present in the remaining patient. Four patients improved after treatment (none of these had clinically complete tetraplegia preoperatively), and three patients died. Associated soft tissue injuries producing spinal cord compression after reduction of cervical locked facets were verified in all of the patients of this series, suggesting that systematic surgical exploration should be done in this category of patients.

Κακώσεις Κατώτερης Αυχενικής Μοίρας Της Σπονδυλικής Στήλης

“…Από την άλλη μεριά θα πρέπει κανείς να έχει υπόψη του ότι οι ασθενείς αυτοί είναι συχνά πολυτραυματίες σε καταστολή ή διασωληνωμένοι στη ΜΕΘ. Η κλειστή ανάταξη σε αυτούς τους ασθενείς μπορεί να ενέχει σοβαρότατες επιπλοκές επί τραυματικής ρήξης του μεσοσπονδυλίου δίσκου (Eismont et al, 1991,Moraes et al, 1995,Olerud and Jonsson, Jr., 1991,Robertson and Ryan, 1992,Berrington et al, 1993. Παρομοίως, αν και η ανοιχτή οπίσθια ανάταξη είναι πολύ αποτελεσματική σε αυτές τις κακώσεις, αυτή αντενδείκνυται χωρίς προηγούμενη μελέτη με MRI.…”