Management of Subaxial Cervical Spine Injury with Unilateral Locked Facet: An Institutional Experience.

Abstract

Aim: To describe a series of 31 surgically managed cases in a single center.

Material and methods: We retrospectively collected data from 31 surgically managed cases that occurred between October 2014 and July 2019. We used the PubMed database to conduct a systematic literature search.

Results: Out of 31 patients, 24 (77.4%) were male and seven (22.6%) were female, with a male-to-female ratio of 3.42:1. The mean age of injury was 45.81 years (range: 25?67 years). In 20 (64.51%) cases, the mode of injury was a fall, followed by a road traffic accident (RTA) in nine (29.03%) cases. The average duration from trauma to admission in the hospital was 8.13 days (range: 0?63 days), and the average duration of hospital stay was 13.03 days (range: 2?36 days). The most commonly involved vertebral level was C5?C6, affecting 16 (51.6%) cases. In 22 (70.96%) cases, closed reduction was achieved, while in nine (29.03%) cases, the reduction was achieved by open reduction. Of the 31 cases, 22 (70.96%) were managed by the anterior approach only, whereas seven were managed by the combined approach.

Conclusion: Subaxial cervical spine subluxation with a unilateral locked facet is an unstable injury; it should be managed surgically. For single-level subluxation with a unilateral locked facet, fixation and fusion from the anterior approach alone are sufficient if the closed reduction is achieved. In case of failed closed reduction, fixation and fusion using the anterior approach alone are sufficient after completing an open reduction from the posterior approach.