Unilateral Biportal Endoscopy-Assisted Posterior Reduction for Irreducible Cervical Facet Dislocation: A Technical Note

Objective: The aim of this study is to describe a novel minimally invasive technique using unilateral biportal endoscopy (UBE) for the posterior reduction of irreducible cervical facet dislocation caused by a fractured articular process.Methods: We present the surgical technique conducted in a patient with irreducible C4–5 facet dislocation refractory to closed traction. The patient underwent posterior UBE in the prone position. Through standard UBE portals, partial resection of the C5 superior articular process and removal of the fractured C4 inferior articular process fragment blocking reduction were performed under direct endoscopic visualization. Gentle manipulation then achieved anatomical reduction. Subsequently, the patient underwent standard C4–5 anterior cervical discectomy and fusion in the supine position.Results: UBE successfully facilitated anatomical reduction by addressing the bony obstruction. Postoperatively, the patient mobilized early and demonstrated full motor power recovery at a 1-month follow-up, with no UBE-related complications.Conclusion: UBE-assisted posterior reduction is a feasible technique for select cases of irreducible cervical facet dislocation with bony obstruction. It enables direct visualization and targeted removal of impediments with minimal soft tissue disruption prior to definitive anterior stabilization, offering a potential alternative to open posterior reduction.