Combined approach for a locked unilateral facet fracture-dislocation of the cervicothoracic junction.

The authors present the case of a 36-year-old patient who sustained a unilateral fracture-dislocation C7-T1 involving all three columns, given the lesion of the C7-T1 disc on MRI. In view of the fractured facet, closed reduction without anaesthesia was not attempted. First, open reduction and instrumentation were performed from posteriorly. In a second operation, anterior fusion C7-T1 was added, using a tricortical bone graft and instrumentation. The authors felt that this three-column lesion at the cervicothoracic junction necessitated combined posterior-anterior stabilisation.