Anterior Facetectomy for Reduction of Cervical Facet Dislocation.

STUDY

DESIGN

Technique report and case series.

OBJECTIVE

The aim of this study was to develop a new surgical technique for anterior reduction in management of unilateral/bilateral facet dislocations and to report the results of 8 patients with successful outcomes associated with this approach.

SUMMARY OF BACKGROUND DATA: The anterior-only surgical procedure, including discectomy, open reduction, fusion, and fixation, is a recommended approach in the treatment of cervical facet dislocations. This approach is with a failure rate of up to 40%. When it fails, a posterior approach is usually required. We have developed a new surgical approach with facetectomy for anterior reduction of cervical facet dislocations. This technique is especially useful for delayed management of unilateral/bilateral facet dislocation patients who failed the conventional anterior open reduction to avoid a posterior procedure.

METHODS

Eight patients with cervical facet dislocations who failed in the conventional anterior reduction were surgically treated by the anterior facetectomy reduction technique. After discectomy, anteromedial foraminotomy was performed by resection of posterior foraminal part or total of uncovertebral joint. After the nerve root was retracted cephalad in the neuroforamina, the edge of the dislocated superior facet was broken to achieve reduction.

RESULTS

Postoperatively, all patients have obtained successful reduction and satisfactory anatomic sagittal alignment. There were no complications attributable to the use of this technique.

CONCLUSION

Anterior facetectomy reduction represents a safe and efficacious but technically challenging option for the treatment of cervical facet dislocation.

LEVEL OF EVIDENCE: 5.