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Vol. 31. Issue 5.
Pages 253-258 (September - October 2020)
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Vol. 31. Issue 5.
Pages 253-258 (September - October 2020)
Case Report
Treatment of old cervical bilateral facet dislocation: Case report and literature review
Tratamiento de las secuelas de una luxación facetaria bilateral cervical: caso clínico y revisión bibliográfica
Marisa Cunhaa,b,1, Pedro Santos Silvaa,b,1,
Corresponding author
pedrodossantossilva@gmail.com

Corresponding author.
, Paulo Pereiraa,b,c,1, Rui Vaza,b,c,1
a Neurosurgery Department, Hospital São João, Porto, Portugal
b Faculty of Medicine, Porto University, Porto, Portugal
c Neuroscience Unit, Hospital CUF Porto, Porto, Portugal
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Table 1. Reports of old bilateral facet dislocations of the cervical spine (CBFD).
Abstract

Late diagnosis of cervical bilateral facet dislocation is rare and contributes to concerns in the management of these patients.

We present a case of a 44-year-old woman presented 8 months after a trauma with persistent neck pain, without neurological deficits. A bilateral C5-C6 facet dislocation was identified. The patient was treated with a combined C5-C6 approach: posterior facet joints release, anterior discectomy and fusion, bilateral posterior fixation. Surgery was performed under intraoperative neurophysiological monitoring. The postoperative period was uneventful, and the patient presented functional improvement.

Late surgical treatment of bilateral cervical facet dislocation is safe and feasible. Combined procedures are needed for proper reduction and stabilization of the spine. Intraoperative neurophysiological monitoring adds value to this technique contributing to good outcomes.

Keywords:
Facet dislocation
Old
Combined approach
Cervical
Spine
Resumen

El diagnóstico tardío de la luxación facetaria bilateral cervical es infrecuente y contribuye a crear problemas en el tratamiento de estos pacientes.

Presentamos el caso de una mujer de 44 años que, 8 meses después de un traumatismo, presentaba dolor continuo en el cuello, en ausencia de deficiencias neurológicas. Se identificó una luxación facetaria bilateral en C5-C6. La paciente recibió tratamiento quirúrgico combinado en C5-C6: liberación posterior de las articulaciones facetarias, discectomía anterior y artrodesis, fijación posterior bilateral. La intervención quirúrgica se realizó con monitorización neurofisiológica intraoperatoria. La paciente presentó una evolución postoperatoria sin complicaciones y mejoría funcional.

El tratamiento quirúrgico tardío de la luxación facetaria cervical bilateral es seguro y viable. Es necesario utilizar procedimientos combinados para lograr una reducción y estabilización correctas de la columna vertebral. La monitorización neurofisiológica intraoperatoria aporta valor añadido a esta técnica y contribuye a lograr buenos resultados.

Palabras clave:
Luxación facetaria
Secuelas
Tratamiento quirúrgico combinado
Cervical
Columna vertebral

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