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European Spine Journal

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01-05-2016 | Case Report

Traumatic L4–5 bilateral locked facet joints

Authors: Georgios A. Zenonos, Nitin Agarwal, Edward A. Monaco III, David O. Okonkwo, Adam S. Kanter

Published in: European Spine Journal | Special Issue 1/2016

Abstract

Introduction

Traumatic bilateral locked facet joints occur with extreme rarity in the lumbar spine. A careful review of the literature revealed only three case reports.

Clinical Presentation

We present the case of a 36 year-old male who suffered bilateral L4–5 facet fracture dislocations following a motor vehicle collision. The dislocation was associated with disruption of the posterior elements and a Grade II anterolisthesis of L4 on L5 as well as an epidural hematoma resulting in severe canal narrowing, with the patient remaining neurologically intact on presentation. The patient underwent open reduction with L3 to S1 pedicle screw fixation and arthrodesis to treat this highly unstable injury.

Conclusion

The existing literature and a biomechanics review of the lumbar spine are described in the context of the presented case in addition to a proposed mechanism for such dislocations.

Deniz FE, Zileli M, Cagli S, Kanyilmaz H (2008) Traumatic L4–L5 spondylolisthesis: case report. Eur Spine J 17(Suppl 2):S232–S235. doi:10.1007/s00586-007-0496-6 CrossRefPubMed

Mori K, Hukuda S, Katsuura A, Saruhashi Y, Asajima S (2002) Traumatic bilateral locked facet at L4–5: report of a case associated with incorrect use of a three-point seatbelt. Eur Spine J 11:602–605. doi:10.1007/s00586-002-0396-8 CrossRefPubMed

Song KJ, Lee KB (2005) Bilateral facet dislocation on L4–L5 without neurologic deficit. J Spinal Disord Tech 18:462–464PubMed

De Das S, McCreath SW (1981) Lumbosacral fracture-dislocations. A report of four cases. J Bone Joint Surg Br 63-B:58–60

Davis AA, Carragee EJ (1993) Bilateral facet dislocation at the lumbosacral joint. A report of a case and review of literature. Spine (Phila Pa 1976) 18:2540–2544

Fabris D, Costantini S, Nena U, Lo Scalzo V (1999) Traumatic L5-S1 spondylolisthesis: report of three cases and a review of the literature. Eur Spine J 8:290–295CrossRefPubMedPubMedCentral

Herron LD, Williams RC (1984) Fracture-dislocation of the lumbosacral spine. Report of a case and review of the literature. Clin Orthop Relat Res (186):205–211

Marras WM (2011) Section I—basic science, biomehanics of the spinal motion segment. In: Herkowitz HN, Eismont FJ, Bell GR, Balderston RA (eds) The spine. Elselvier-Saunders, Philadephia, pp 109–129

Dewey P, Browne PS (1968) Fracture-dislocation of the lumbo-sacral spine with cauda equina lesion. Report of two cases. J Bone Joint Surg Br 50:635–638PubMed

10.

Fardon DF (1976) Displaced fracture of the lumbosacral spine with delayed cauda equina deficit: report of a case and review of literature. Clin Orthop Relat Res (120):155–158

11.

Morris BD (1981) Unilateral dislocation of a lumbosacral facet. A case report. J Bone Joint Surg Am 63:164–165PubMed

12.

Zoltan JD, Gilula LA, Murphy WA (1979) Unilateral facet dislocation between the fifth lumbar and first sacral vertebrae. Case report. J Bone Joint Surg Am 61:767–769PubMed

Title: Traumatic L4–5 bilateral locked facet joints
Authors: Georgios A. Zenonos
Nitin Agarwal
Edward A. Monaco III
David O. Okonkwo
Adam S. Kanter
Publication date: 01-05-2016
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue Special Issue 1/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-015-4245-y

ACC 2024 Congress

Springer Medicine

Traumatic L4–5 bilateral locked facet joints

Abstract

Introduction

Clinical Presentation

Conclusion

ACC 2024 Congress

Springer Medicine

Abstract

Introduction

Clinical Presentation

Conclusion

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