Borruto Maria Ilaria, Pomponi Michele, Velluto Calogero, Marciano Achille, Proietti Luca, Scaramuzzo Laura
Department of Aging, Orthopaedic and Rheumatological Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.
J Clin Med. 2025 Sep 3;14(17):6228. doi: 10.3390/jcm14176228.
Traumatic dislocation of the lumbosacral facet joints without associated fractures is exceedingly rare in the pediatric population. Due to the unique anatomical and biomechanical features of the pediatric spine, such injuries present diagnostic and therapeutic challenges. This study aims to describe a rare case of bilateral L5-S1 jumped facets without fracture in a 13-year-old boy and to review the existing literature on pediatric traumatic facet dislocations. We performed a systematic review according to PRISMA guidelines, searching PubMed, Embase, Scopus, and the Cochrane Library up to 16 January 2025. Keywords included "pediatric traumatic spondylolisthesis" and "pediatric traumatic facet joint". Eligible studies reported traumatic lumbosacral or thoracolumbar facet dislocations in patients aged <18 years. In addition, we report the clinical course, surgical management, and outcome of a representative case from our institution. The systematic review identified 14 pediatric cases across 11 studies. Most patients were male (71.4%), with high-energy trauma as the primary mechanism. The L5-S1 level was most frequently involved (57.1%). Neurological impairment was present in 57.1% of cases. All patients underwent surgical treatment, with posterior fixation being the most common approach. Our case involved bilateral L5-S1 jumped facets without fracture, successfully treated with open reduction and posterior fusion. Postoperative recovery was favorable, with neurological improvement. Traumatic bilateral facet dislocation without fracture is an extremely rare but serious condition in pediatric patients. Early recognition and surgical stabilization are essential to prevent permanent neurological damage. This study reinforces the importance of advanced imaging and prompt multidisciplinary management in optimizing outcomes.
腰骶小关节创伤性脱位且无相关骨折在儿科人群中极为罕见。由于儿童脊柱独特的解剖和生物力学特征，此类损伤带来了诊断和治疗方面的挑战。本研究旨在描述一名13岁男孩双侧L5 - S1小关节跳跃而无骨折的罕见病例，并回顾有关儿童创伤性小关节脱位的现有文献。我们根据PRISMA指南进行了系统评价，检索了截至2025年1月16日的PubMed、Embase、Scopus和Cochrane图书馆。关键词包括“儿童创伤性脊椎滑脱”和“儿童创伤性小关节”。符合条件的研究报告了年龄<18岁患者的创伤性腰骶或胸腰小关节脱位。此外，我们报告了我们机构一个代表性病例的临床过程、手术治疗及结果。系统评价在11项研究中确定了14例儿科病例。大多数患者为男性（71.4%），主要机制为高能量创伤。L5 - S1水平最常受累（57.1%）。57.1%的病例存在神经功能障碍。所有患者均接受了手术治疗，后路固定是最常见的方法。我们的病例为双侧L5 - S1小关节跳跃而无骨折，通过切开复位和后路融合成功治疗。术后恢复良好，神经功能有所改善。创伤性双侧小关节脱位且无骨折在儿科患者中是一种极其罕见但严重的情况。早期识别和手术稳定对于预防永久性神经损伤至关重要。本研究强化了先进影像学检查和及时多学科管理在优化治疗结果方面的重要性。
