Closed reduction of locked facets

• Odontoid Fracture with Locked Posterolateral Atlantoaxial Dislocation: A Case Report and Review of Literature
• Management of Lunate Facet Escape after Distal Radius Fracture Volar Plating: Surgical Technique
• Convergent dislocation of the elbow in adults: A retrospective study
• Surgical outcome of locked facet in distractive flexion injury of the subaxial cervical spine: Single institution retrospective study
• Surgical Treatment of Irreducible AcuteTraumatic Atlantoaxial Rotatory Subluxation in an Adult
• Classification of unilateral cervical locked facet with or without lateral mass-facet fractures and a retrospective observational study of 55 cases
• Subaxial Cervical Spine Injuries: WFNS Spine Committee Recommendations
• Anterior Approach Following Intraoperative Reduction for Cervical Facet Fracture and Dislocation

Contraindicated if traumatic cervical disc herniation is demonstrated on MRI.

Cervical spine fracture-dislocations in neurologically intact patients represent a surgical challenge due to the risk of inflicting iatrogenic spinal cord compression by closed reduction maneuvers. The use of MRI for early advanced imaging in these injuries remains controversially debated.

The diagnostic evaluation of cervical fracture-dislocations should include advanced imaging by MRI in order to fully understand the injury pattern prior to proceeding with spinal reduction maneuvers which may impose the imminent threat of a devastating iatrogenic injury to the spinal cord. The presented staged management by initial Halo fixation without attempts for spinal reduction, followed by a surgical decompression and multilevel fusion, appears to represent a feasible and safe strategy for patients at risk of a delayed neurological injury ¹⁾.

Patients who cannot be assessed neurologically may be done using SSEP/MEP monitoring. Two methods of closed reduction:

• Multicentre comparative study of Z-shape elevating-pulling reduction and skull traction reduction for treatment of lower cervical locked facets
• Management of irreducible unilateral facet joint dislocations in subaxial cervical spine: two case reports and a review of the literature
• Cervical Posttraumatic Unilateral Locked Facets: Clinical, Radiologic, and Surgical Remarks on a Series of 33 Patients
• Treatment of cervical dislocation with locked facets
• Closed reduction of bilateral locked facets of the cervical spine under general anaesthesia

Halo-vest-assisted Z-shape elevating-pulling reduction appears to be a simple, safe, and effective technique for pre-operative reduction of lower cervical locked facets ²⁾.

Unilateral facet joint dislocations of subaxial cervical spine are difficult to reduce when complicated with posterior facet fractures or ligamentous injury. Magnetic resonance imaging can be beneficial for identifying ventral and dorsal compressive lesions, as well as ligamentous or capsule rupture. The combination of posterior reduction and anterior fixation with fusion has advantages in terms of clinical safety, ease of operation, and less iatrogenic damage ³⁾.