Traumatic L4–5 bilateral locked facet joints

Introduction Traumatic bilateral locked facet joints occur with extreme rarity in the lumbar spine. A careful review of the literature revealed only three case reports. Clinical Presentation We present the case of a 36 year-old male who suffered bilateral L4–5 facet fracture dislocations following a...

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Bibliographic Details
Published in:European spine journal 2016-05, Vol.25 (Suppl 1), p.129-133
Main Authors: Zenonos, Georgios A., Agarwal, Nitin, Monaco, Edward A., Okonkwo, David O., Kanter, Adam S.
Format: Article
Language:English
Subjects:
Accidents, Traffic
Adult
Case Report
Fracture Dislocation - etiology
Fracture Dislocation - surgery
Hematoma, Epidural, Spinal - etiology
Hematoma, Epidural, Spinal - surgery
Humans
Lumbar Vertebrae - injuries
Lumbar Vertebrae - surgery
Male
Medicine
Medicine & Public Health
Neurosurgery
Surgical Orthopedics
Zygapophyseal Joint - injuries
Zygapophyseal Joint - surgery
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Summary:Introduction Traumatic bilateral locked facet joints occur with extreme rarity in the lumbar spine. A careful review of the literature revealed only three case reports. Clinical Presentation We present the case of a 36 year-old male who suffered bilateral L4–5 facet fracture dislocations following a motor vehicle collision. The dislocation was associated with disruption of the posterior elements and a Grade II anterolisthesis of L4 on L5 as well as an epidural hematoma resulting in severe canal narrowing, with the patient remaining neurologically intact on presentation. The patient underwent open reduction with L3 to S1 pedicle screw fixation and arthrodesis to treat this highly unstable injury. Conclusion The existing literature and a biomechanics review of the lumbar spine are described in the context of the presented case in addition to a proposed mechanism for such dislocations.
ISSN:0940-6719
1432-0932
DOI:10.1007/s00586-015-4245-y