An unusual presentation of bilateral facet dislocation of the cervical spine.
We report the case of a patient who presented complaining of neck pain after a fall. Initial physical examination was remarkable for an occipital scalp contusion and tenderness to palpation in the mid-cervical spine. Neurological examination demonstrated an absence of response to pinprick below approximately the T4 level. Upper extremities had equal withdrawal to pain and lower extremities were without movement. Initial cervical, thoracic, and lumbar spine films were normal. An emergency myelogram demonstrated a complete extradural block at the C6 level. Cross-table lateral cervical spine films revealed a C5-C6 bilateral facet dislocation. The patient subsequently underwent closed reduction with in-line-traction. He had a prolonged hospital course and was eventually transferred for rehabilitation, with some improvement in neurologic status.
Department of Emergency Health Services, Truman Medical Center, Kansas City, Missouri 64108.
J A
JA
Salomone
M T
MT
Steele
D000328:Adult; D004632:Emergency Medical Services; D006801:Humans; D007103:Immobilization; D004204:Joint Dislocations / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology / Q000601:surgery / Q000628:therapy; D008297:Male; D009192:Myelography; D009333:Neck; D009460:Neurologic Examination; D013119:Spinal Cord Injuries / Q000209:etiology; D013123:Spinal Fusion; D013124:Spinal Injuries / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery / Q000628:therapy; D014143:Traction