Unilateral and bilateral facet dislocations of the cervical spine

Introduction to unilateral and bilateral facet joint dislocation of the cervical spine The dislocation of the joint with or without fracture is a serious injury. Because it causes deformation of the fibrous fiber of the spinal canal, it is bound to constitute compression of the nerve tissue. The incidence of spasticity caused by spinal cord involvement is more than 70%, and 90% of cases are reported, especially in cases of simultaneous dislocation of bilateral joints. Therefore, this group of cases must be highly valued. basic knowledge The proportion of illness: 0.002% Susceptible people: no special people Mode of infection: non-infectious Complications: spinal cord injury

Causes of unilateral and bilateral facet joint dislocation of the cervical spine

(1) Causes of the disease

Dislocation of the bilateral cervical facet joints caused by violence from the posterior cervical spine.

(two) pathogenesis

Cervical vertebrae suffer from mild violence in the case of mild flexion, which may cause bilateral cervical facet joints (jumping), which is a complete injury; while flexion plus rotation causes a lateral facet joint dislocation, which is clinically relative Rarely, it is also an unstable injury. After the joint dislocation, whether the violence continues and the degree of spinal nerve production is different, the spinal cord of the spinal canal may not be tired. This is the so-called "lucky joint dislocation", the joint dislocation is good. It occurs in the neck 4~5 and the neck 5~6. The pathological anatomy shows that in addition to joint dislocation (interlocking), the ligaments and other soft tissues around the joint are also affected at the same time, especially the joint capsule ligament injury is the heaviest, most of them Or all fractures, and the anterior longitudinal ligament and posterior longitudinal ligament, the interspinous and supraspinous ligaments can also have different degrees of damage, the incidence of spinal cord injury is about 80%, the incidence of bilateral dislocation is more than one side The rate is 8 percentage points higher, the former 55% is complete cervical spinal cord injury, and the latter is 40%.

Prevention of unilateral and bilateral facet joint dislocation in cervical vertebrae

No major obstacles, mainly pay attention to life, and find timely treatment.

Complications of unilateral and bilateral facet joint dislocation of the cervical spine Complications spinal cord injury

Sometimes spinal cord or nerve root damage can occur.

Cervical unilateral and bilateral facet joint dislocation symptoms Common symptoms Head and neck activity restricted nerve root injury Neck dorsal muscle spasm forced body position neck and neck pain

1. Forced position Due to the interlocking of the small joints, the patient is forced to bend forward due to the "fracture" of the head and neck. It requires both hands to hold the head and has a fixed elastic sign. On the one hand, the head and neck turn to the opposite side. With anterior flexion position (can be determined from the midline of the ankle to the healthy side).

2. The neck pain is due to the dislocation of the joint, the local tensile stress and the tensile stress rise sharply, causing unbearable pain. The performance of one side is heavier on one side, and the other side is more symptomatic due to joint occlusion variation. .

3. The cervical tendon is more obvious. In addition to the dislocation of the joint, it is directly related to the tearing of the muscle fiber at the same time as the trauma. The unilateral side is mostly the paraspinal tendon of the affected side or the cervical tendon. The degree is heavier than the healthy side.

4. Other general symptoms and signs including neck injury are easy to find. Patients with spinal cord and/or spinal nerve root injury should pay attention to the location and degree of judgment, and should maintain the stability of the neck.

Examination of unilateral and bilateral facet joint dislocation of the cervical spine

X-ray plain film (positive position, lateral position and oblique position), tomography and CT examination are easy to show the dislocation of the facet joint, and there is no difficulty in judging unilateral or bilateral (Fig. 1). Perform an MRI to determine the damage to the spinal cord.

Diagnosis and diagnosis of unilateral and bilateral facet joint dislocation of cervical vertebrae

1. History of trauma Learn whether there is violence that causes the cervical spine to bend forward, and whether there is rotation and direction in the head and neck at the moment of injury.

2. The clinical manifestations are as described above, with severe neck pain, paraspinal tendon and forced position.

3. Imaging examination X-ray film (positive position, lateral position and oblique position), tomography and CT examination are easy to show the dislocation of the facet joint, and it is not difficult to judge unilateral or bilateral (Fig. 1). Patients with spinal cord injury need to have an MRI to determine the damage to the spinal cord.

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