Bilateral facet dislocation with myelopathy

Case contributed by Tanzilur Rahman
Diagnosis certain

Presentation

Pain and loss of sensation in both upper limbs following trauma

Patient Data

Age: 55 years
Gender: Male
  • moderate anterior displacement of C5 over the C6 vertebra is noted with intervening disc space reduction resulting in severe spinal canal stenosis and cervical cord compression

  • both facet joints are deformed at the C5-C6 level. The inferior articular process of C5 has jumped anteriorly over the superior articular facet of the C6 vertebra on both sides

  • T2WI hyperintense signal change is seen within the cervical cord at C5-C7 levels

  • hyperintense signal change is seen within posterior cervical soft tissues (interspinous regions) in T2WI and fluid-sensitive images

Case Discussion

Imaging features suggest bilateral facet dislocation resulting in grade II spondylolisthesis of the C5 vertebra over the C6 vertebra associated with compressive myelopathy and interspinous ligament injury.

Bilateral facet dislocation is a severe form of hyperflexion injury. It is an unstable injury and is often associated with rotational force.

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