Abstrakt
Cervical facet dislocations are potentially devastating injuries which account for 75 % of subaxial spine injuries. Classification, timing of surgery and types of fixation vary between surgeons and there is still no gold standard.
There remains open debate regarding the role of MRI in the diagnostics and selection of the optimal treatment strategy, anterior, posterior or combined approach. In the presence or suspicion of disc herniation behind the displaced vertebral body, anterior approach is indicated.
Posterior approach alone is recommended in cases where successful closed awake reduction was achieved or the presence of disc herniation was ruled out by MRI. Because most of these injuries lead to significant damage of both the anterior and posterior column, combined approach is commonly performed, especially in poly-traumatized, alcoholics or other non-compliant patients or in those with additional injury of the superior end-plate of the inferior vertebra.