Facet dislocation (bilateral, cervical spine)
In bilateral facet dislocation both facets have dislocated and/or fractured. On X-ray the affected vertebral body is displaced by at least a half its length forwards.
Initial treatment centres around reduction of the dislocation. This can be achieved by heavy skull traction for a few hours. If the facets are locked this may fail. Manipulation under relaxation or open reduction from the back may be required.
Once the dislocation is reduced:
- Traction may be continued for six weeks followed by a cervical collar for six weeks or...
- A halo body cast may be worn for eight weeks or...
- A posterior fusion may be performed followed by a cervical brace for eight weeks.
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