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Facet Fracture

   

 

synonyms:

Facet Fracture ICD-9

Facet Fracture Etiology / Epidemiology / Natural History

  • Common, generally involve the superior facet.

Facet Fracture 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

    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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