title: Traumatic bilateral locked facet at L4-5: report of a case associated with incorrect use of a three-point seatbelt.
abstract: We present a case of traumatic L4-5 bilateral facet dislocation, without neurological deficit, in a 32-year-old female patient, as an unusual seatbelt injury caused by positioning the shoulder harness improperly under her armpit. Open reduction, posterior interbody fusion, and posterior segmental instrumentation were carried out. The aim of this report is to describe this rarely encountered condition and speculate regarding automotive shoulder harness misuse as a potential cause of bilateral locked facet at L4-5, and to emphasize the importance of multidirectional X-ray on first examination. The unusual L4-5 level facet interlocking was attributed to misuse of the automobile shoulder harness. We propose the importance of recognizing this injury and following up on such clues as transverse process fractures and/or widened posterior elements.
authors.affiliation: Department of Orthopaedic Surgery, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, 520-2192, Japan. kanchi@belle.shiga-med.ac.jp
authors.forename: Kanji
authors.initials: K
authors.lastname: Mori
authors.forename: Sinsuke
authors.initials: S
authors.lastname: Hukuda
authors.forename: Akitomo
authors.initials: A
authors.lastname: Katsuura
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Saruhashi
authors.forename: Shuzo
authors.initials: S
authors.lastname: Asajima
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D008279:Magnetic Resonance Imaging; D012622:Seat Belts / Q000009:adverse effects*; D013123:Spinal Fusion; D013124:Spinal Injuries / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D014057:Tomography, X-Ray Computed