title: [Reduction of traumatic dislocations and facet fracture-dislocations in the lower cervical spine].
abstract: BACKGROUND
  Traumatic facet dislocations and facet-fracture dislocations in the lower cervical spine (C2/C3 to C7/T1) are frequently associated with devastating neurological symptoms. A good outcome can only be achieved if the operator has wide and sound knowledge of reduction techniques and the best possible strategy is devised for the subsequent treatment of these severe lesions.
  
  
  METHODS
  Between 1973 and 1997 a total of 117 of our patients met at least one of the following inclusion criteria: unilateral locked facet dislocation (48%), bilateral locked facet dislocations (23%), unilateral "perched" facet subluxation (14%), bilateral perched facet subluxation (12%), uni- or bilateral dislocation/perched subluxation with facet fractures (3%).
  
  
  RESULTS
  Most of the lesions were located at the levels of C5/C6 and C6/7 (n=46 for each). Associated neurological deficits were present initially in 65% of patients: 35% had complete or incomplete spinal cord injuries (tetraplegia), 2% were paraplegic, and 28% had cervical radiculopathies.
  
  
  CONCLUSIONS
  Closed reduction (e.g. with the aid of a halo ring) should be carried out as soon as possible after lower cervical spine dislocation or facet-fracture dislocation, as both the success rate of reduction and the potential for recovery from neurological deficits are clearly higher when reduction is achieved within the first 4 h after the initial injury.
authors.affiliation: Universitätsklinik für Unfallchirurgie und Sporttraumatologie, Medizinische Universität Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria. maximilian.reinhold@uklibk.ac.at
authors.forename: M
authors.initials: M
authors.lastname: Reinhold
authors.forename: C
authors.initials: C
authors.lastname: Knop
authors.forename: U
authors.initials: U
authors.lastname: Lange
authors.forename: R
authors.initials: R
authors.lastname: Rosenberger
authors.forename: R
authors.initials: R
authors.lastname: Schmid
authors.forename: M
authors.initials: M
authors.lastname: Blauth
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000293:injuries* / Q000601:surgery; D002648:Child; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D010264:Paraplegia / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology; D011782:Quadriplegia / Q000209:etiology; D011843:Radiculopathy / Q000209:etiology; D020127:Recovery of Function; D013119:Spinal Cord Injuries / Q000601:surgery; D016103:Spinal Fractures / Q000601:surgery*; D013124:Spinal Injuries / Q000601:surgery*