Journal of Spine & NeurosurgeryISSN: 2325-9701

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Case Report, J Spine Neurosurg Vol: 4 Issue: 4

Bilateral Facet Dislocation with Neural Compression from an Avulsed Posterior Longitudinal Ligament

Bradford S. Waddell1*, John Trey Glomset1, Brandon Cook1 and Joseph M. Zavatsky2
1Ochsner Medical Center, 1514 Jefferson Highway, New Orleans, LA 70121, USA
2Florida Orthopedic Institute, 13020 Telecom Parkway North, Tampa, FL 33637, USA
Corresponding author : Bradford S. Waddell
Ochsner Medical Center, 1514 Jefferson Highway, New Orleans, LA 70121, USA
Tel: 318-465-3037
E-mail: [email protected]
Received June 23, 2015 Accepted September 26, 2015 Published October 03, 2015
Citation: Waddell BS, Glomset JT, Zavatsky JM, Cook B (2015) Bilateral Facet Dislocation with Neural Compression from an Avulsed Posterior Longitudinal Ligament. J Spine Neurosurg 4:4. doi: 10.4172/2325-9701.1000197

Abstract

Background and Importance: A review of the literature failed to show evidence of normal appearing posterior longitudinal ligament avulsion as a cause of spinal cord compression after bilateral cervical facet dislocations. We report a case of the posterior longitudinal ligament (PLL) avulsion causing spinal cord compression after bilateral cervical facet dislocation. Clinical presentation: A 93 year female presented with upper extremity numbness and bilateral C5-C6 facet dislocations. The patient was immediately taken for closed reduction and anterior cervical decompression with fusion (ACDF). After awake, closed reduction, an ACDF was immediately performed. After a complete discectomy procedure, the spinal cord could be visualized secondary to an absent PLL. A nerve hook was used to explore behind the C6 vertebral body to decompress the spinal cord. A segment of normal appearing posterior longitudinal ligament, which had avulsed from the superior aspect of C5, was found folded behind the C6 vertebra causing cord compression. There was no herniated disk material discovered. Conclusion: In addition to herniated disk material, avulsed PLL is another potential source of cord compression after closed reduction of cervical facet dislocations and surgeons must be aware of this possible source of compression while exploring and decompressing the spinal canal. This case study elucidates that the PLL is a potential cause of spinal cord compression after traumatic bilateral cervical facet dislocations.

Keywords: Facet, Dislocation, Stenosis, Posterior longitudinal ligament, Cervical

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