Treatment of isolated cervical facet fractures: a systematic review

Treatment of isolated cervical facet fractures: a systematic review

There is a new publication about isolated facet fractures (here). The list of authors is a list of the well known AO Spine experts. Most of them contributed to the new AO Spine classification of thoracolumbar spine injuries and cervical spine injuries. Their work is very important for us, because they put all the experience we have made within the last three decades into scientific evidence. You know: nothing is more frustrating than to learn, that all of your strategy, your philosophy and your opinion of doing it right and treating your patients the best way ends in a statement, that there is no scientific evidence, that your work is good – or even worse than an alternative treatment. Remember for example all these discussions about vertebroplasty 2008-2011. Until now, I hear from several (non-operative) people, that there is no value in cement augmentations…

So, we have to thank these authors for investing so much time and work, because it’s an effort for all of us. We can now show our patients, that there are good reasons to perform open reduction and fixations. This treatment seems to be superior to closed reduction and external immobilization.

And this is important for us, because often you need a quick decision. Leaving the facet facture dislocation in situ is not an option. So it’s an important study for us spine surgeons who are trauma surgeons as well!


Journal of Neurosurgery: Spine
Feb 2016 / Vol. 24 / No. 2 / Pages 347-354


Christopher K. Kepler, MD, MBA1, Alexander R. Vaccaro, MD, PhD, MBA1, Eric Chen, MD2, Alpesh A. Patel, MD3, Henry Ahn, MD, PhD4, Ahmad Nassr, MD5, Christopher I. Shaffrey, MD6, James Harrop, MD2, Gregory D. Schroeder, MD1, Amit Agarwala, MD7, Marcel F. Dvorak, MD8, Daryl R. Fourney, MD9, Kirkham B. Wood, MD10, Vincent C. Traynelis, MD11, S. Tim Yoon, MD, PhD12, Michael G. Fehlings, MD, PhD13, and Bizhan Aarabi, MD14

1Department of Orthopaedic Surgery, Rothman Institute & Thomas Jefferson University Hospital, Philadelphia, Pennsylvania; 2Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania; 3Department of Orthopaedic Surgery, Northwestern Memorial Hospital, Chicago, Illinois; Departments of 4Orthopaedic Surgery and 13Neurosurgery,
University of Toronto, Ontario, Canada; 5Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota; 6Department of Neurosurgery, University of Virginia, Charlottesville, Virginia; 7Panorama Orthopedics & Spine Center, Denver, Colorado; 8Department of Orthopaedic Surgery, University of British Columbia, Vancouver, British Columbia, Canada; 9Department
of Neurosurgery, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; 10Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts; 11Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois; 12Department of Orthopaedic Surgery, Emory University, Atlanta, Georgia; and 14Department of Neurosurgery,
University of Maryland, Baltimore, Maryland

submitted December 14, 2014. accepted June 4, 2015.
Published online October 30, 2015; DOI: 10.3171/2015.6.SPINE141260