Türk Nöroşirürji Dergisi 1998 , Vol 8 , Num 2
TREATMENT OPTIONS FOR CERVICAL TRAUMATIC LOCKED FACETS
Mehmet ZİLELİ1, Erdal COŞKUN2, Sertaç İŞLEKEL1, Kazım ÖNER1, İzzet ÖVÜL1, Nurcan ÖZDAMAR1
1Ege Üniversitesi Tıp Fakültesi Nöroşirürji Anabilim Dalı, İzmir
2Pamukkale Üniversitesi Tıp Fakültesi Nöroşirürji Anabilim Dalı, Denizli
Fourty-five patients with cervical traumatic locked facets were treated at the Department of Neurosurgery of Ege University School of Medicine during 14 years period (1978-1992). In 33 patients there were unilateral and in 12 patients bilateral locked facets. Most of the dislocations were at C6-C7 level (38%). All patients underwent a closed skeletal traction initially. For the cases that the reduction was successful, bone fusion with anterior approach was used. During the last years, this procedure was combined with a plate stabilization. If the reduction was not successful via skeletal traction, a posterior surgery together with an open reduction and instrumentation was applied. In 15 cases stabilized with anterior approach, 9 patients developed deformity, and 3 of them were operated again with posterior stabilization and 2 had a Halo jacket. In 30 cases treated with posterior approach, 9 patients have developed deformity, of which 3 had a Halo jacket. In general, we achieved closed reduction in approximately 40% of the patients who had skeletal tractions during the first 7 days of their injury. However, none of the patients receving skeletal tractions were reducted after 7 days. Presence of a facet fracture also did not effect the reduction. In conclusion, traumatic cervical locked facets is a serious trauma type with high morbidity. There is no simple algorhytm for these cases. Anahtar Kelimeler : Cervical Fracture, cervical locked facet, frankel scores, spinal cord injuries