Cervical facet dislocation: Difference between revisions
(Created page with "==Background== *Is an unstable spine injury ==Clinical Features== ===Diagnosis=== ==Differential Diagnosis== {{Cervical spine injuries}} ==Wor...") |
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==Background== | ==Background== | ||
==Clinical Features== | ==Clinical Features== | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Workup== | ==Workup== | ||
*[[C-Spine X-Ray]] | *[[C-Spine X-Ray]] | ||
*determine if more than 1 spinal column affected | *determine if more than 1 spinal column affected | ||
** 1 column = generally stable | ** 1 column = generally stable | ||
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*abnormal xray? -> get CT | *abnormal xray? -> get CT | ||
==Management== | |||
===Prehospital Immobilization=== | |||
See [[EBQ:Prehospital Spine Immobilization|NAEMSP National Guidelines for Spinal Immobilization]] | |||
===Hospital=== | |||
===Bilateral=== | ===Bilateral=== | ||
*Unstable as whole column can sublux | *Unstable as whole column can sublux | ||
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**Anterior x-ray: affected spinous process points toward side that is dislocated | **Anterior x-ray: affected spinous process points toward side that is dislocated | ||
*Spinal cord injury rarely occurs | *Spinal cord injury rarely occurs | ||
==Disposition== | |||
==See Also== | |||
*[[Spinal Cord Trauma]] | |||
*[[Cervical spine injuries]] | |||
[[Category:Trauma]] | |||
[[Category:Ortho]] | |||
Revision as of 04:00, 2 January 2015
Background
Clinical Features
Differential Diagnosis
Vertebral fractures and dislocations types
- Cervical fractures and dislocations
- Thoracic and lumbar fractures and dislocations
Workup
- C-Spine X-Ray
- determine if more than 1 spinal column affected
- 1 column = generally stable
- 2 or more columns = unstable
- generally superior facet fx
- abnormal xray? -> get CT
Management
Prehospital Immobilization
See NAEMSP National Guidelines for Spinal Immobilization
Hospital
Bilateral
- Unstable as whole column can sublux
- high risk for significant spinal cord injury
- Disruption of annulus fibrosus and ant longitudinal ligament > ant displacement of spine
- Imaging
- Lateral xray: vertebral body will be displaced ~50% of its width
- Management
- spinal precautions
- operative management: nsg vs ortho
Unilateral
- Relatively Stable
- Presentation
- C5/C6: C6 radiculopathy with weakness to wrist extension numbness and tingling in the thumb
- C6/C7: C7 radiculopathy with weakness to triceps and wrist flexion and numbness in index and middle finger
- Imaging
- Lateral x-ray: vertebral body will be displaced ~25% of its width
- Anterior x-ray: affected spinous process points toward side that is dislocated
- Spinal cord injury rarely occurs