National Spinal Injuries Unit, Department of Trauma & Orthopaedic Surgery, Mater Misericordiae University Hospital, Dublin, Ireland.
School of Medicine, Trinity College Dublin, Dublin, Ireland.
Ir Med J. 2020 Jul 30;113(7):131.
Introduction Bilateral cervical facet dislocation (BCFD) is an uncommon injury with a high incidence of severe neurological impairment. We describe 4 cases of BCFD with preserved neurological function. Cases Case 1: A 78-year-old female who suffered two ground level falls (GLFs). Pre-operative American Spinal Injury Association (ASIA) Score was C5D. Imaging revealed a BCFD at C6/C7 and a C6 laminar fracture. Case 2: A 63-year-old male suffered a fall down 14 steps. Pre-operative ASIA score was E. Imaging demonstrated a BCFD at C7/T1, and a C6 laminar fracture. Case 3: A 46-year-old male collided with a tree while descending a hill on a bicycle. Pre-operative ASIA score was C6D. Imaging revealed a BCFD at C7/T1 and a C7 laminar fracture. Case 4: A 67-year-old male suffered a GLF while exiting a stationary car. Pre-operative ASIA score on admission was E. Imaging revealed a BCFD at C6/C7 with bilateral laminar fractures at C5 and C6. Outcome All cases underwent 2-stage surgical fixation. All cases maintained or had an improved ASIA score post-operatively. Conclusion In all cases, the presence of concurrent laminar fractures resulted in an auto-decompression of the spinal canal, preserving neurological function.
介绍
双侧颈椎小关节脱位（BCFD）是一种罕见的损伤，伴有较高的严重神经功能损伤发生率。我们描述了 4 例保留神经功能的 BCFD 病例。
病例 1：一名 78 岁女性，因两次平地跌倒（GLF）而受伤。术前美国脊髓损伤协会（ASIA）评分 C5D。影像学显示 C6/C7 双侧小关节脱位和 C6 椎板骨折。
病例 2：一名 63 岁男性，从 14 级台阶上坠落。术前 ASIA 评分为 E。影像学显示 C7/T1 双侧小关节脱位和 C6 椎板骨折。
病例 3：一名 46 岁男性骑自行车下山时与一棵树相撞。术前 ASIA 评分为 C6D。影像学显示 C7/T1 双侧小关节脱位和 C7 椎板骨折。
病例 4：一名 67 岁男性从停驶的汽车中出来时 GLF。入院时术前 ASIA 评分为 E。影像学显示 C6/C7 双侧小关节脱位，C5 和 C6 双侧椎板骨折。
结果
所有病例均行 2 期手术固定。所有病例术后均保持或改善了 ASIA 评分。
结论
在所有病例中，同时存在的椎板骨折导致椎管自动减压，从而保留了神经功能。
