Facet dislocation (bilateral, cervical spine)

In bilateral facet dislocation both facets have dislocated and/or fractured. On X-ray the affected vertebral body is displaced by at least a half its length forwards.

Initial treatment centres around reduction of the dislocation. This can be achieved by heavy skull traction for a few hours. If the facets are locked this may fail. Manipulation under relaxation or open reduction from the back may be required.

Once the dislocation is reduced:

• Traction may be continued for six weeks followed by a cervical collar for six weeks or...
• A halo body cast may be worn for eight weeks or...
• A posterior fusion may be performed followed by a cervical brace for eight weeks.