A rare case of lumbar facet fracture‐dislocation and review of the literature

Traumatic lumbar facet dislocation is an uncommon condition, particularly when unilateral lumbar facet dislocation is accompanied by a contralateral facet fracture. The patient had a locked facet joint at the left L4-L5, a fracture of the right superior articular process of L5 and a comminuted fracture at the peritrochanteric region of the right femur following a fall. Emergent operation was conducted, starting with open reduction and fixation for the right proximal femur, followed by posterior open reduction and posterolateral fusion with instrumentation, without interbody fusion, for the lumbar spine injury. The patient exhibited positive outcomes throughout the follow-up. This article highlights the trauma mechanism of lumbar facet dislocation, emphasizing hyperflexion with rotational force. Abnormal local scoliosis is a distinctive imaging sign of facet joint dislocation. Facetectomy and laminectomy are recommended for safe reduction and instrumented fusion is considered a safe and effective surgical treatment for facet joint dislocation injuries.

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Publication Details

Journal
Clinical Case Reports
Published
2024-10-24
DOI
https://doi.org/10.1002/ccr3.9510
Primary Topic
Spinal Fractures and Fixation Techniques
Type
article
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article

A rare case of lumbar facet fracture‐dislocation and review of the literature

Kin Weng Wong, Chien-Chieh Wang, Chi‐Sheng Chien, Tsung‐Mu Wu et al.
Clinical Case Reports
Spinal Fractures and Fixation Techniques
article

A rare case of lumbar facet fracture‐dislocation and review of the literature

Kin Weng Wong, Chien-Chieh Wang, Chi‐Sheng Chien, Tsung‐Mu Wu, Chun‐Hsiung Huang
article en

Abstract

Traumatic lumbar facet dislocation is an uncommon condition, particularly when unilateral lumbar facet dislocation is accompanied by a contralateral facet fracture. The patient had a locked facet joint at the left L4-L5, a fracture of the right superior articular process of L5 and a comminuted fracture at the peritrochanteric region of the right femur following a fall. Emergent operation was conducted, starting with open reduction and fixation for the right proximal femur, followed by posterior open reduction and posterolateral fusion with instrumentation, without interbody fusion, for the lumbar spine injury. The patient exhibited positive outcomes throughout the follow-up. This article highlights the trauma mechanism of lumbar facet dislocation, emphasizing hyperflexion with rotational force. Abnormal local scoliosis is a distinctive imaging sign of facet joint dislocation. Facetectomy and laminectomy are recommended for safe reduction and instrumented fusion is considered a safe and effective surgical treatment for facet joint dislocation injuries.

Clinical Case ReportsVol. 12(11)
Chi Mei Medical Center (TW), National Cheng Kung University (TW)
Good health and well-being
Openalex Percentile: Top 65%
Spinal Fractures and Fixation Techniques
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A rare case of lumbar facet fracture‐dislocation and review of the literature — Kin Weng Wong, Chien-Chieh Wang, et al. · Clinical Case Reports (2024) | TGRS Research Map | TGRS