Treatment of Irreducible Bilateral Cervical Facet Fracture-Dislocation with a Prolapsed Disc Using a Prefixed Polyetheretherketone Cage and Plate System

When anterior reduction fail in the surgical treatment of cervical bilateral facet fracture-dislocation with concomitant disc extrusion, it is necessary to perform a reduction using a posterior approach and then a third anterior procedure is often necessary to accomplish the anterior reconstruction. This presents difficulties for both patients and surgeons because of the need for frequent position changes (supine-prone-supine). The purpose of this study is to illustrate a modified surgical technique, which is anterior reduction and fixation with a prefixed polyetheretherketone (PEEK) cage to a buttress plate for the treatment of irreducible bilateral cervical facet fracture-dislocation with a prolapsed disc is an enhancing technique for the stability of the interbody graft than a buttress plate alone because the PEEK cage has more fixation power and reduces both the number of position changes and the length of the operation.

Anterior Reduction and Stabilization of Unilateral Locked Facet of Cervical Spine

OBJECTIVE: We present an evaluation of the safety and effectiveness of anterior reduction and stabilization of unilateral locked facet of the cervical spine. METHODS: Nine patients with unilateral locked facet of the cervical spine were treated with anterior decompression, reduction and stabilization from January 1997 through December 2000. There were six male and three female patients who ranged in age from 22 to 59 years (average 37.4 years). The level of facet dislocation was C4-5 in one, C5-6 in four, and C6-7 in four patients. One patient presented with complete spinal cord injury, two patients with incomplete spinal cord injury, four patients with radioculopathy, and two patients were neurologically intact. All patients underwent plain radiogram, computed tomogram scan, and magnetic resonance imaging. All patients underwent surgery for anterior open reduction, decompression and stabilization using bone graft and anterior cervical plate fixation systems. The mean follow-up periods was 11.9 months. RESULTS: All patients showed good decompression, reduction and stabilization without postoperative complications. Two patients showed vertebral artery thrombosis at facet locked side, but no cerebral ischemic symptoms. Follow-up neurological status was unchanged in two patients and improved in 7 patients. No patient experienced neurological deterioration or complications after this procedure. All patients showed good bony fusion without instability at follow-up period. CONCLUSION: Our results show that anterior decompression, reduction and stabilization procedure are safe and effective method in unilateral locked facet of the cervical spine without significant complications.