Cervical facet dislocation

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Vertebral fractures and dislocations types

Vertebral anatomy.
Numbering order of vertebrae.

Clinical Features

  • Generally from hyperflexion mechanism such as rapid deceleration
  • Frequently associated with spinal cord injury when bilateral

Differential Diagnosis

Neck Trauma


  • C-Spine X-Ray[1]
  • determine if more than 1 spinal column affected
    • 1 column = generally stable
    • 2 or more columns = unstable
  • generally superior facet fracture
  • abnormal xray? → get CT


Prehospital Immobilization

See NAEMSP National Guidelines for Spinal Immobilization



  • 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
Bilateral facet dislocation: although there are no bony fractures, displacement of one vertebra over the inferior disturbs the spinal canal


  • 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


  • Unilateral Facet Dislocation
    • Given stability can be placed in a cervical collar and follow up with neurosurgery as an outpatient
  • Bilateral Facet Dislocation
    • Emergent neurosurgical evaluation

See Also


  1. Diaz, J. J., Aulino, J. M., Collier, B. R., Roman, C. D., May, A. K., Miller, R. S. and Guillamondegui, O. D. (2004) ‘THE EARLY WORK-UP FOR ISOLATED LIGAMENTOUS INJURY OF THE CERVICAL SPINE: DOES CT-SCAN HAVE A ROLE?’, The Journal of Trauma: Injury, Infection, and Critical Care, 57(2), p. 453