Chipman Danielle E, Ryan Thomas J, Lucasti Christopher, Kowalski David, Vallee Emily K, Scott Maxwell M, Yunke Alexander, Clark Lindsey D, Kowalski Joseph M
Jacobs School of Medicine and Biomedical Sciences.
Department of Orthopaedics, Jacobs School of Medicine and Biomedical Science, University at Buffalo, Buffalo, NY.
Clin Spine Surg. 2025 Jun 19. doi: 10.1097/BSD.0000000000001864.
Retrospective case series.
The objective of this study is to report on the demographics, symptoms, and treatment course of a series of adult trauma patients who presented with jumped facets.
Jumped facets are rare traumatic cervical spine injuries that result in significant instability. These can be unilateral or bilateral, and they are often associated with serious spinal cord injuries.
All patients over 18 years old who presented at a single level 1 trauma center between September 2015 to March 2023 with a cervical spine injury were identified. Patients were included if they had jumped facets diagnosed on computed tomography (CT) scans. Patients were excluded if they were under 18 years old and/or did not have a diagnosis of jumped facets. Demographics, cervical spine characteristics, American Spinal Injury Association (ASIA) impairment scale scores, treatment course, and intrahospital data for all patients were collected.
Of the 554 patients identified, 11 patients met the final inclusion and exclusion criteria. The average age of the participants was 50.6 ± 22.1 years; 72.7% were male. The most common mechanism of injury, 9 (81.8%) patients, was a motor vehicle crash (MVC). All injury levels fell between levels C4 and C7. Six (54.5%) patients had motor and sensory deficits. Two (18.2%) patients had an ASIA score of A. All patients underwent surgical treatment, and 7 (63.6%) patients were treated with both an anterior and posterior approach. Patients spent a median of 12.0 (IQR: 10.0) days in the hospital.
In this series of patients, the majority of patients who sustained jumped facets were middle-aged men who were involved in an MVC. While most patients did not have complete spinal cord injuries, all patients underwent urgent reduction and stabilization. Therefore, in an attempt to best help patients regain as much function as possible, we recommend prompt reduction and stabilization.
Level IV.
回顾性病例系列。
本研究的目的是报告一系列出现颈椎小关节交锁的成年创伤患者的人口统计学特征、症状和治疗过程。
颈椎小关节交锁是罕见的创伤性颈椎损伤，会导致严重的不稳定。这些损伤可以是单侧或双侧的，并且常与严重的脊髓损伤相关。
确定2015年9月至2023年3月期间在单一的一级创伤中心就诊的所有18岁以上颈椎损伤患者。如果患者在计算机断层扫描（CT）上被诊断为颈椎小关节交锁，则纳入研究。如果患者年龄在18岁以下和/或未被诊断为颈椎小关节交锁，则排除。收集所有患者的人口统计学特征、颈椎特征、美国脊髓损伤协会（ASIA）损伤量表评分、治疗过程和院内数据。
在确定的554例患者中，11例符合最终纳入和排除标准。参与者的平均年龄为50.6±22.1岁；72.7%为男性。最常见的损伤机制是机动车碰撞（MVC），有9例（81.8%）患者。所有损伤节段均在C4至C7节段之间。6例（54.5%）患者有运动和感觉功能障碍。2例（18.2%）患者的ASIA评分为A级。所有患者均接受了手术治疗，7例（63.6%）患者接受了前路和后路联合治疗。患者在医院的中位住院时间为12.0（四分位间距：10.0）天。
在这一系列患者中，大多数发生颈椎小关节交锁的患者是参与机动车碰撞的中年男性。虽然大多数患者没有完全性脊髓损伤，但所有患者均接受了紧急复位和固定。因此，为了尽可能帮助患者恢复更多功能，我们建议及时进行复位和固定。
四级。
