Abstract
IntroductionThere have been few reports of patients with bilateral cervical facet dislocations that remain untreated for eight weeks or more. We report the case of a 76-year-old man with an old bilateral cervical facet joint dislocation fracture that was treated by posterior-anterior reduction and fixation.Case presentationA 76-year-old Asian man was involved in a road traffic accident. He presented with neck pain and arm pain on his right side, but motor weakness and paralysis were not observed. He was treated conservatively; however, instability and spondylolisthesis at the C5 to C6 joint increased eight weeks after the injury. We performed a posterior-anterior reduction and fixation. After surgery, bony union was achieved, and his neck pain and arm pain disappeared.ConclusionWe recommend reduction and fixation surgery if a patient has an old bilateral facet joint dislocation fracture in the cervical spine.
Highlights
There have been few reports of patients with bilateral cervical facet dislocations that remain untreated for eight weeks or more
We recommend reduction and fixation surgery if a patient has an old bilateral facet joint dislocation fracture in the cervical spine
The rate of misdiagnosis ranges from 5% to 20% [1,2,3]
Summary
Several authors have reported failures to correctly diagnose cervical spine injuries. We report a case of a 76-year-old man with an old bilateral cervical facet joint dislocation fracture that was treated by posterior-anterior reduction and fixation. Case presentation A 76-year-old Asian man was involved in a road traffic accident He presented with neck and arm pain on his right side, but motor weakness and paralysis were not observed. X-ray imaging, MRI and CT eight weeks after the injury (Figures 1a,b,c, 2 and 3). Plain X-ray film images obtained at this time showed increased instability at the C5 to C6 joint when compared with those taken immediately after the accident (Figure 1a,b,c). MRI revealed recovery of the central spinal canal stenosis at the C5 to C6 joint and showed normal intensity in the spinal cord on T2-weighted imaging (Figures 2 and 5)
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