Facet Fractures

synonyms:

Facet Fracture ICD-9

Facet Fracture Etiology / Epidemiology / Natural History

• Common, generally involve the superior facet.

Facet Fracture Anatomy

• See Spine anatomy.

Facet Fracture Clinical Evaluation

• Palpate entire spine for tenderness / step off.
• Complete neuro exam: motor strength, pin-prick sensation, reflexes, cranial nerves, rectal examination (perineal pin-prick sensation, sphincter tone, volitional spincter control)
• Absence of the bulbocaverosus reflex indicates spinal shock. Level of spinal injury can not be determined until bulbocaverosus reflex has returned.
• See ASIA form.

Facet Fracture Xray / Diagnositc Tests

• A/P, Lateral, Odontoid: easily missed on plain films
• CT cervical spine:
• MRI:

Facet Fracture Classification / Treatment

• Unilateral, Nondisplaced, no subluxation: orthosis for 6-12 weeks.
• Unilateral, >40% of lateral mass height, or with associated discoligamentous disruption: are unstable. Treatment = fusion
• Bilateral: unstable. Treatment = fusion
• Floating lateral mass fracture: lamina and ipsilateral pedicle of the same segment are fractured, assoicated with radiculopathy. Treatment = fusion

Facet Fracture Associated Injuries / Differential Diagnosis

• Occipital Condyle Fracture
• Occipitocervical Dissociation
• Atlas fracture
• C2 fracture
• Odontoid fracture
• Facet Dislocation
• Burst Fracture
• Compression Fracture
• Spinal Cord Injury

Facet Fracture Complications

Facet Fracture Follow-up Care

Facet Fracture Review References

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