Surgical treatment for unilateral cervical facet dislocation in a young child aged 22 months old: a case report and review of the literature

22个月大幼儿单侧颈椎小关节脱位的手术治疗:病例报告及文献复习

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Abstract

PURPOSE: Cervical unilateral facet dislocation (UFD) in the younger children (0-10 years old) has rarely been reported in the literature and most surgeons have no experience for this kind of injury. Here, we reported a rare case of cervical UFD in a 22-month-old girl. METHODS: Clinical and radiological findings of this patient were described. Because closed reduction failed, operative reduction and fixation was performed using titanium miniplates. We also reviewed the related literature. RESULTS: There was a significant improvement in neurological function during the follow-up period, and no complications developed. To our knowledge, the only similar case reported in the literature was a 9-year-old boy, who was successfully treated by closed reduction and immobilized with a rigid cervical collar. CONCLUSIONS: Cervical UFD in young children is definitely a great challenge, and each patient requires individual treatment. Closed reduction along with rigid immobilization is the first choice at the early stage, and operative treatment is indicated for cases that involved neurological deterioration, demonstrated recurrence,significant instability and failed closed reduction. However, long-term results and complications of surgical treatment in the pediatric population are worrisome.

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