Pedro Luiz Ribeiro Carvalho de Gouvea, Pedro Henrique da Costa Ferreira-Pinto, Domênica Baroni Coelho de Oliveira Ferreira, Camila de Oliveira Ribeiro, Armando Yoshimitsu Hamada, Leonardo Antunes Miguez, César Batista Gonçalves da Cruz, Eduardo Mendes Correa, George da Silva Divério Junior, Flávio Nigri
{"title":"外伤性C6-C7骨折脱位伴手术矫正前路硬体融合失败及忽视锁定小关节：1例报告及文献复习。","authors":"Pedro Luiz Ribeiro Carvalho de Gouvea, Pedro Henrique da Costa Ferreira-Pinto, Domênica Baroni Coelho de Oliveira Ferreira, Camila de Oliveira Ribeiro, Armando Yoshimitsu Hamada, Leonardo Antunes Miguez, César Batista Gonçalves da Cruz, Eduardo Mendes Correa, George da Silva Divério Junior, Flávio Nigri","doi":"10.1159/000550932","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The cervical spine represents the most common site of spinal trauma, typically associated with vertebrae dislocation with locked facets. Accurate assessment of the entire spine is essential to prevent diagnostic and therapeutic failures. Here, we present a case of a patient with C6-C7 dislocation who underwent two unsuccessful surgical procedures, highlighting the technical challenges associated with revision surgery and persistent facet locking.</p><p><strong>Case description: </strong>A 26-year-old male arrived at an emergency hospital after a motorcycle accident with paraplegia, C6 roots strength grade 2, and C7, C8, and T1 paralysis. The cervical computed tomography scan revealed C6-C7 dislocation, left C7-T1 locked facet, and right C6-C7 facet subluxation. After two unsuccessful surgical procedures, a combined 540-degree posterior-anterior-posterior (P-A-P) approach was performed. After the combined P-A-P cervical spine approach, the patient remained paraplegic, with no further neurological deterioration during follow-up.</p><p><strong>Conclusion: </strong>Early diagnosis and management of locked facets is crucial to avoid unstable constructions and subsequently hardware failure in patients with cervical spinal trauma.</p>","PeriodicalId":9639,"journal":{"name":"Case Reports in Neurology","volume":"18 1","pages":"163-169"},"PeriodicalIF":0.6000,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13068387/pdf/","citationCount":"0","resultStr":"{\"title\":\"Traumatic C6-C7 Fracture-Dislocation with Surgical Correction of Anterior Hardware Fusion Failure and Neglected Locked Facet: A Case Report and Literature Review.\",\"authors\":\"Pedro Luiz Ribeiro Carvalho de Gouvea, Pedro Henrique da Costa Ferreira-Pinto, Domênica Baroni Coelho de Oliveira Ferreira, Camila de Oliveira Ribeiro, Armando Yoshimitsu Hamada, Leonardo Antunes Miguez, César Batista Gonçalves da Cruz, Eduardo Mendes Correa, George da Silva Divério Junior, Flávio Nigri\",\"doi\":\"10.1159/000550932\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The cervical spine represents the most common site of spinal trauma, typically associated with vertebrae dislocation with locked facets. Accurate assessment of the entire spine is essential to prevent diagnostic and therapeutic failures. Here, we present a case of a patient with C6-C7 dislocation who underwent two unsuccessful surgical procedures, highlighting the technical challenges associated with revision surgery and persistent facet locking.</p><p><strong>Case description: </strong>A 26-year-old male arrived at an emergency hospital after a motorcycle accident with paraplegia, C6 roots strength grade 2, and C7, C8, and T1 paralysis. The cervical computed tomography scan revealed C6-C7 dislocation, left C7-T1 locked facet, and right C6-C7 facet subluxation. After two unsuccessful surgical procedures, a combined 540-degree posterior-anterior-posterior (P-A-P) approach was performed. After the combined P-A-P cervical spine approach, the patient remained paraplegic, with no further neurological deterioration during follow-up.</p><p><strong>Conclusion: </strong>Early diagnosis and management of locked facets is crucial to avoid unstable constructions and subsequently hardware failure in patients with cervical spinal trauma.</p>\",\"PeriodicalId\":9639,\"journal\":{\"name\":\"Case Reports in Neurology\",\"volume\":\"18 1\",\"pages\":\"163-169\"},\"PeriodicalIF\":0.6000,\"publicationDate\":\"2026-02-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13068387/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Case Reports in Neurology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1159/000550932\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2026/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Case Reports in Neurology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1159/000550932","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Traumatic C6-C7 Fracture-Dislocation with Surgical Correction of Anterior Hardware Fusion Failure and Neglected Locked Facet: A Case Report and Literature Review.
Background: The cervical spine represents the most common site of spinal trauma, typically associated with vertebrae dislocation with locked facets. Accurate assessment of the entire spine is essential to prevent diagnostic and therapeutic failures. Here, we present a case of a patient with C6-C7 dislocation who underwent two unsuccessful surgical procedures, highlighting the technical challenges associated with revision surgery and persistent facet locking.
Case description: A 26-year-old male arrived at an emergency hospital after a motorcycle accident with paraplegia, C6 roots strength grade 2, and C7, C8, and T1 paralysis. The cervical computed tomography scan revealed C6-C7 dislocation, left C7-T1 locked facet, and right C6-C7 facet subluxation. After two unsuccessful surgical procedures, a combined 540-degree posterior-anterior-posterior (P-A-P) approach was performed. After the combined P-A-P cervical spine approach, the patient remained paraplegic, with no further neurological deterioration during follow-up.
Conclusion: Early diagnosis and management of locked facets is crucial to avoid unstable constructions and subsequently hardware failure in patients with cervical spinal trauma.
期刊介绍：
This new peer-reviewed online-only journal publishes original case reports covering the entire spectrum of neurology. Clinicians and researchers are given a tool to disseminate their personal experience to a wider public as well as to review interesting cases encountered by colleagues all over the world. To complement the contributions supplementary material is welcomed. The reports are searchable according to the key words supplied by the authors; it will thus be possible to search across the entire growing collection of case reports with universally used terms, further facilitating the retrieval of specific information. Following the open access principle, the entire contents can be retrieved at no charge, guaranteeing easy access to this valuable source of anecdotal information at all times.
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