Spinal instrumentation for interfacet locking injuries of the subaxial cervical spine.

ABSTRACT

A retrospective analysis of our surgical management of traumatic interfacet locking was performed. Eleven interfacet locking injuries were surgically treated. An anterior procedure was performed in five patients, posterior fixation in three and a combined procedure in three. Five facet locks were reduced by preoperative skull traction. After general anesthesia at surgery, another two cases were corrected manually. Surgical fixation using spinal instrumentation was performed. One patient treated with posterior fixation required an additional anterior procedure because of a delayed disc herniation. Spinal instrumentation avoided a halo vest. The anterior approach may be selected in patients who are reduced manually, while a combined procedure should be performed in patients with irreducible facet dislocation with disc herniation. Delayed symptomatic disc herniation may occur when only posterior fixation is performed.