An unusual presentation of bilateral facet dislocation of the cervical spine

Ann Emerg Med. 1987 Dec;16(12):1390-3. doi: 10.1016/s0196-0644(87)80429-8.

Abstract

We report the case of a patient who presented complaining of neck pain after a fall. Initial physical examination was remarkable for an occipital scalp contusion and tenderness to palpation in the mid-cervical spine. Neurological examination demonstrated an absence of response to pinprick below approximately the T4 level. Upper extremities had equal withdrawal to pain and lower extremities were without movement. Initial cervical, thoracic, and lumbar spine films were normal. An emergency myelogram demonstrated a complete extradural block at the C6 level. Cross-table lateral cervical spine films revealed a C5-C6 bilateral facet dislocation. The patient subsequently underwent closed reduction with in-line-traction. He had a prolonged hospital course and was eventually transferred for rehabilitation, with some improvement in neurologic status.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Emergency Medical Services
  • Humans
  • Immobilization
  • Joint Dislocations / diagnostic imaging*
  • Joint Dislocations / etiology
  • Joint Dislocations / physiopathology
  • Joint Dislocations / surgery
  • Joint Dislocations / therapy
  • Male
  • Myelography
  • Neck
  • Neurologic Examination
  • Spinal Cord Injuries / etiology
  • Spinal Fusion
  • Spinal Injuries / diagnostic imaging*
  • Spinal Injuries / physiopathology
  • Spinal Injuries / surgery
  • Spinal Injuries / therapy
  • Traction