Surgical treatment for irreducible pediatric subaxial cervical unilateral facet dislocation: case report

Abstract

<jats:p>Unilateral facet dislocation at the subaxial cervical spine (C3–7) in children younger than 8 years of age is rare. The authors describe a surgical approach for irreducible subaxial cervical unilateral facet dislocation (SCUFD) at C3–4 in a 5-year-old boy and present a literature review. A dorsal unilateral approach was applied, and a biodegradable plate was used for postreduction fixation without fusion after failed conservative treatment. There was complete resolution of symptoms and restored cervical stability. Two years after surgery, the patient had recovered range of motion in C3–4. In selected cases of cervical spine injury in young children, a biodegradable plate can maintain reduction until healing occurs, obviate the need to remove an implant, and recover the motion of the injured segment.</jats:p>

Treatment of chronic bilateral facet dislocation in a 6-year-old: A case report

“…Quinn et al 7 used posterior reduction and fixation in a 4-year-old child, where lateral mass screws were used on one side and sublaminar wire on the other side for bilateral perched facets. Qu et al 15 reported on a 5-year-old who presented with unilateral jumped facet, and they had deterioration in neurophysiology signals during closed reduction. Therefore, they performed an open posterior reduction and used a bioabsorbable plate for stabilisation.…”

Subaxial cervical trauma surgical approach and neurological outcome

“…This approach, however, has the disadvantage regarding the instrumentation placing and complication such as instrumentation failure, nerve palsy, artery occlusion, fistula, infection, hemorrhage and thrombotic episodes [54,26,13] . The approach is seldom used in children because of the hazard of postoperative instability and distortion [9] . Despite that fact, the neurological outcome of this age group seems to be outstanding.…”

“…Age Improvement rate (%) Approach Chen et al [4] 1,8 100 posterior Li et al [5] 3 100 anterior+posterior Anissipour et al [6] 14,9 36,36 anterior+posterior Sellin et al [7] 12,4 96,88 anterior+posterior Momaya et al [8] 10 100 posterior Qu et al [9] 5 100 anterior Dogan et al [10] 12,4 72,55 anterior Shaked et al [11] 9,5 100 anterior Hooley et al [12] 3 100 posterior [13] 67 75 anterior Yokoyama et al [14] 79 100 posterior Yamazaki et al [15] 62 100 posterior Bartels et al [16] 71,33 91,67 anterior+posterior Moon et al [17] 62 100 anterior Raizman et al [18] 55 100 anterior Yang et al [19] 55,42 75 anterior+posterior Han et al [20] 78 100 anterior+posterior Abumi et al [21] 56 54,35 posterior…”