Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
JBJS Rev. 2022 May 1;10(5):01874474-202205000-00005. doi: e22.00023.
»: Flexion-distraction, axial loading, and rotational forces can cause various degrees of osseoligamentous disruption of the cervical spine, leading to traumatic cervical facet fractures and dislocations.
»: Low-energy forces lead to minimally displaced facet fractures that often can be treated with immobilization only. High-energy forces are more likely to cause unstable injuries with or without neurologic compromise, which may require surgical intervention.
»: The initial treatment of cervical facet injuries requires patient evaluation and management through the Advanced Trauma Life Support (ATLS) protocols, while definitive management varies based on the biomechanical components of the injury, the neurologic status of the patient, and additional patient factors.
»: Cervical facet injuries often require a multidisciplinary approach to optimize long-term functional outcomes and minimize serious complications.
»: 屈伸分离、轴向加载和旋转力可导致颈椎不同程度的骨韧带破坏,进而引起创伤性颈椎小关节骨折和脱位。
»: 低能量力导致小关节骨折轻微移位,通常仅通过固定即可治疗。高能量力更可能导致不稳定损伤,伴有或不伴有神经损伤,可能需要手术干预。
»: 颈椎小关节损伤的初始治疗需要通过高级创伤生命支持 (ATLS) 方案进行患者评估和管理,而明确的治疗方法则根据损伤的生物力学成分、患者的神经状态以及其他患者因素而有所不同。
»: 颈椎小关节损伤通常需要多学科方法来优化长期功能结果并最大程度减少严重并发症。