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Traumatic bilateral L4-5 facet fracture dislocation: a case presentation with mechanism of injury.

Authors:
Kevin Chi Him Fok Jason Pui Yin Cheung

BMC Musculoskelet Disord 2019 Nov 23;20(1):558. Epub 2019 Nov 23.

Department of Orthopaedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.

Background: Traumatic bilateral locked facet joints at L4-5 level are a rare entity. A careful review only revealed four case reports. This case presented with an unusual mechanism of injury.

Case Presentation: We present a case of a 40-year-old male who suffered bilateral L4-5 traumatic facet fracture dislocation following a fall injury. The dislocation was associated with fractures of bilateral L4 inferior articular processes, left L4 pedicle, L4 spinous process and postero-inferior body of L4. He presented with cauda-equina syndrome and underwent emergency decompression, reduction and instrumented fusion.

Conclusion: The biomechanics of the lumbar spine may differ with each individual. L4-5 dislocation may be a variant to lumbosacral (L5-S1) dislocation, owing to hyperextension injury.

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Source
http://dx.doi.org/10.1186/s12891-019-2921-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6875427PMC
November 2019

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