Cervical facet dislocation

From WikEM
Jump to: navigation, search


Clinical Features

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

Differential Diagnosis

Cervical Spine Fractures and Dislocations


  • 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



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


  • 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


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