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Bilateral C6/7 locked facet dislocation

Case contributed by Noyan Zenger
Diagnosis almost certain

Presentation

History of fall one day ago and bilateral complete paraplegia. X-ray done initially but plain X-rays were not sufficient for a proper diagnosis and then CT scan performed.

Patient Data

Age: 60 years
Gender: Male

C6-7 anterolistesis and bilateral locked facet dislocation.

The first image shows the normal relation of facet joints, the “hamburger bun” sign.

The second image shows the “reverse hamburger bun” sign, caused by locked facet dislocation.

Bilateral C6-7 anterolistesis, facet dislocation and cord compression.

Case Discussion

X-ray was done initially but plain radiographs were not sufficient for a proper assessment and a further CT scan performed.

Sagittal MPR of CT scan shows bilateral C6/7 anterolistesis and facet dislocation.

Sagittal T2W images show high signal intensity in the spinal cord on T2-weighted imaging.

Closed reduction was unsuccessful. The patient was therefore selected for an open reduction.

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