Pediatric Cervical Spine Injuries: Lessons From a Rare Case of C5/C6 Facet Dislocation in an Adolescent With a Systematic Literature Review.

Abstract

Objectives: Traumatic cervical spine injuries in pediatric populations are uncommon, accounting for 1% to 10% of spinal trauma cases. Cervical facet dislocations are particularly rare and usually result from high-energy trauma. This study presents a rare instance of a C5/C6 facet dislocation caused by a low-energy mechanism during judo and discusses management strategies based on a literature review.

Methods: This work includes a case report of a 15-year-old male with a C5/C6 facet dislocation sustained during judo practice. Imaging confirmed vertebral malalignment and a herniated disc without spinal cord compression. The patient was treated with closed reduction, followed by anterior cervical discectomy and fusion (ACDF), incorporating a polyetheretherketone cage and titanium plating. In addition, a systematic literature review was conducted to evaluate current evidence and recommendations for the management of similar injuries in pediatric populations.

Results: Postoperative outcomes showed significant pain relief and a full recovery within three months. Radiographs confirmed spinal stability and successful fusion. The literature review highlighted a variety of surgical and non-surgical strategies, emphasizing the need for tailored management approaches. Long-term follow-up considerations included potential growth-related deformities and adjacent segment degeneration.

Conclusions: This case underscores the complexity of diagnosing and treating cervical spine injuries in adolescents, especially following low-energy trauma. Successful outcomes rely on individualized treatment approaches and a multidisciplinary framework. Further research is necessary to refine management strategies for these rare injuries in pediatric populations.