Akademik Veri Yönetim Sistemi
Journal of Turkish Spinal Surgery, cilt.32, sa.4, ss.154-159, 2021 (Scopus)
Various strategies are suggested for facet joint dislocations after cervical trauma. The effect of timing of surgery on neurological outcome is controversial, both early and late surgeries have advantages and disadvantages. We aimed to investigate the neurological results of early versus late surgery for traumatic subaxial cervical facet joint dislocations. We also aimed to investigate the effect of unilateral and bilateral injuries on neurological recovery.
The data of 23 consecutive patients with facet joint dislocation between 2013-2020 were retrospectively analyzed. The data of age, gender, spinal level and side, surgical strategy, surgical timing, neurological status, and prognosis were collected from medical reports. Surgery within the first 24 hours of trauma was defined as early surgery and surgery after 24 hours of trauma was defined as late surgery. The effect of timing of surgery and unilateral or bilateral nature of the injury on neurological outcome were investigated at one-year follow-up.
In a total of 19 patients with neurological deficits, early surgery resulted in neurological recovery in 7 of 12 patients (p=0.001), and late surgery resulted in neurological recovery in 2 of 7 patients (p=0.135). While 8 of 12 patients with unilateral dislocation showed neurological recovery (p=0.002), only 3 of 11 patients with bilateral facet joint dislocations showed neurological recovery (p=0.061).
Early surgery may result in better neurological outcomes at one-year follow up than late surgery. Patients with unilateral facet joint dislocation have better prognosis than bilateral injuries in terms of neurological recovery.
Keywords: Cervical trauma, subaxial cervical spine, facet joint dislocation, early surgery, traumatic disc herniation