How to Reduce Bilateral Cervical Facet Joint Dislocation in Anterior Approach: A Trick to Avoid Anterior-Posterior-Anterior Surgical Procedures

Abstract

Introduction Cervical facet joint dislocation is a common injury of the lower cervical spine. These flexion distraction lesions in cervical spine occur as a subluxation or unilateral/bilateral dislocation of the facet joints, which often be accompanied by direct spinal cord and nerve root injury. The presence of herniated intervertebral disc requires an anterior approach to decompress the spinal cord. Because often it is not possible to reduce facet joint dislocation while performing anterior surgery an additional posterior approach and then the fixation trough an anterior approach again is necessary. This method (supine-prone-supine) creates difficulties for surgeons because of the prolonged operation time; the need for frequent changes in patient position; and a subsequent high incidence of complications. Materials and Methods On the basis of a case, we present a maneuver to use pins such as joysticks in vertebral body during anterior approach to reduce dislocated facet joints in cervical spine fractures. After cervical discectomy/corpectomy, we use the pins to put the vertebral body in kyphotic position following rotational motion to reduce the facet joints. Results and Conclusion: Since we implemented this procedure, we had no more to perform posterior approach in surgical treatment in the last 15 cases of bilateral facet joint dislocation with herniated intervertebral disc in cervical trauma.