title: Clinical outcomes of the surgical treatment of isolated unilateral facet fractures, subluxations, and dislocations in the pediatric cervical spine: report of eight cases and review of the literature.
abstract: OBJECTIVE
  We present a small series consisting of eight children with unilateral facet injury of the cervical spine treated surgically.
  
  
  METHODS
  A retrospective review was performed. Injury data, radiographs, surgical data, and outcomes (Neck Disability Index (NDI), Short Form 36 (SF-36), and Visual Analog Scale for Neck Pain (VAS-NP)) were collected from seven patients. A literature review was performed for one additional case.
  
  
  RESULTS
  Motor vehicle accidents (62 %, n = 5) and falls (38 %, n = 3) accounted for all injuries. The C6-7 level accounted for most of the injuries (37.5 %, n = 3). The mean NDI score with at least 3 months follow-up was 5.3 (n = 6, range, 1-12; standard deviation, 4.5), corresponding to mild disability. Of the norm-based SF-36 scale scores available (n = 6), the mean physical functioning (PF), role-physical (RP), and role-emotional (RE) scores were significantly less than the adult, age 18-24, norm-based means, with a mean difference of -6.4, -9.13, and -11.3, respectively (p value = 0.03, 0.001, and 0.01, respectively). The mean general health (GH) and vitality (VT) scores, however, were significantly greater than the adult, age 18-24, norm-based mean, with a mean difference of 7.82 and 10.3 (p = 0.04 and 0.02, respectively). VAS-NP showed a return to the "no pain" level at 3 months or more follow-up in all patients.
  
  
  CONCLUSIONS
  We suggest that surgical treatment of these injuries in the pediatric age group may lead to satisfactory clinical and radiographic outcomes, but HRQoL analysis suggests that patients remain physically and emotionally disabled to some degree after surgery.
authors.affiliation: Neuro-Spine Program, Division of Pediatric Neurosurgery, Department of Neurosurgery, Baylor College of Medicine, Texas Children's Hospital, 6621 Fannin Street, CCC 1230.01, 12th Floor, Houston, TX, 77030, USA.
authors.forename: Jonathan N
authors.initials: JN
authors.lastname: Sellin
authors.forename: Kashif
authors.initials: K
authors.lastname: Shaikh
authors.forename: Sheila L
authors.initials: SL
authors.lastname: Ryan
authors.forename: Alison
authors.initials: A
authors.lastname: Brayton
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Fulkerson
authors.forename: Andrew
authors.initials: A
authors.lastname: Jea
mesh_terms: D000293:Adolescent; D002574:Cervical Vertebrae / Q000293:injuries* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery*; D008297:Male; D010147:Pain Measurement; D016103:Spinal Fractures / Q000601:surgery*; D013123:Spinal Fusion; D016896:Treatment Outcome; D021801:Zygapophyseal Joint / Q000601:surgery*