Background: Facet dislocations of the lumbar spine, particularly without neurologic injury, are rare occurrences after major trauma. Although there are documented cases of lumbosacral dislocation in the published literature, strictly lumbar unilateral facet dislocation is rare.
Case Description: We report a case of a unilateral facet dislocation at L4-L5 after a single vehicle motorcycle accident. This injury was treated with posterior open reduction and instrumented stabilization with good results.
Conclusions: Given the rarity of this injury pattern, the management of this type of injury is not established. Careful imaging to make the diagnosis is crucial, and we recommend a surgical treatment in the form of an open reduction and instrumented stabilization. In our case, we achieved good outcomes with a posterior approach.
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http://dx.doi.org/10.1016/j.wneu.2018.12.006 | DOI Listing |
J Neurosurg Spine
December 2024
2Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and.
Objective: There is a paucity of high-quality return-to-play (RTP) data following treatment of cervical spine injuries in contact sports. In this study, the authors gathered insights from National Football League (NFL) team spine surgeon consultants to highlight current practices in treating cervical spine injuries and report decision-making regarding RTP in professional American football players.
Methods: A cross-sectional, online survey was distributed to all NFL consulting physicians specializing in the management of spine injuries.
Arch Orthop Trauma Surg
December 2024
Harborview Medical Center, University of Washington School of Medicine, Seattle, Seattle, USA.
Traumatic lumbosacral instability (TLSI) generally refers to a traumatic disruption of the lumbopelvic junction. The ambiguous use of this term has contributed to confusion and limited understanding of injuries that can impact lumbosacral stability. As of now, TLSI lacks a clear definition, and the underlying injury patterns remain inadequately characterized.
View Article and Find Full Text PDFClin Orthop Relat Res
December 2024
Department of Orthopaedic Surgery, University Medical Centre Groningen and Groningen University, Groningen, the Netherlands.
Background: The terrible triad injury involves an ulnohumeral dislocation, radial head fracture, and coronoid process fracture. According to traditional teaching, these injuries are strongly associated with anterolateral coronoid tip fractures and can be addressed via a lateral approach to the elbow. However, recent small clinical series suggest that some terrible triad injuries have larger coronoid fractures involving the anteromedial facet.
View Article and Find Full Text PDFJ Surg Orthop Adv
December 2024
McLaren-Flint, Flint, Michigan; Kettering University, Flint, Michigan.
In cases of cervical facet dislocations, traction is typically delivered in the acute setting with tongs attached to the skull via two pins. Although the pins are recommended to be inserted symmetrically in a neutral loading position, erroneous asymmetric pin placement has been documented in case reports, but its biomechanical implications are unknown. The current study utilized a human surrogate to evaluate the influence of asymmetrically placed pins in the axial or frontal planes.
View Article and Find Full Text PDFKey Clinical Message: Lumbar facet fracture-dislocation is rare, often due to hyperflexion with rotational force. Abnormal scoliosis on radiography is a key sign, prompting further imaging. Facetectomy and laminectomy ensure safe reduction, while instrumented fusion is an effective surgical treatment.
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