Unilateral cervical facet fracture: presentation of two cases and literature review.

Abstract

Two patients with diagnosis of unilateral cervical facet fracture due to motor vehicle accident (MVA) are presented, and the literature is reviewed. To discuss the diagnostic difficulties and management strategies in two patients with post-traumatic cervical facet fracture. Department of Neurosurgery, Zonguldak Karaelmas University, Faculty of Medicine, Turkey. Nonoperative treatment with immobilization was preferred in two female cases (33-34 years old) with diagnosis of C6-7 facet fracture following MVA. Magnetic resonance imaging (MRI) could be performed in acute period in the first case, but not in the second because of inadequate technical condition. The first case with a good compliance to immobilization recovered without any neurological complication. However, the second case mobilized earlier and used a collar irregularly. Instability developed in the second case on the second month and surgical intervention with anterior approach was performed. The diagnosis of unilateral facet fractures is often missed and the treatment is still controversial. The compliance of the patient to cervical immobilization in nonoperative treatment plays a very important role in the development of late complications. MRI in the acute period may be useful in determining instability.