Abstract
INTRODUCTION AND IMPORTANCE: When the cervical spine is subjected to flexion-rotation violence, it is easy to cause posterior cervical facet locked, with some patients a 'tip-to-tip' locked. Treatments are needed to perform, including reattaching the facet joint locked, dealing with the injured intervertebral disc, decompressing the spinal canal, and reconstructing the stability of the cervical spine. Each procedure is a challenge for the surgeon, so that there is no standardized surgical plan for these patients (Li et al., 2019 [1]). This case report described a typical patient who achieved a successful operation of ACDF after skull traction reattachment of the unilateral locking facet and C2-C3 transverse dislocation, which provided a reference for the surgical options for such patients. CASE PRESENTATION: The patient was a 67-year-old male patient. His chief complaint was that six hours before arriving at the hospital, he suffered a car accident which caused his persistent neck pain with no effective measures of pain relief and his neck could not move. There were no such accompanying symptoms as nausea, vomiting, dizziness, and headache. Physical examination showed that the patient's limbs had no obvious limitation of movement and no symptoms of nervous injury. However, the right side of the patient's neck was significantly swollen, and the trachea was shifted to the left, The patient had no history of chronic diseases such as hypertension, diabetes, and coronary heart disease. CLINICAL DISCUSSION: For patients with single-segment cervical disc tear without neurological symptoms combined with vertebral body laterally shifted and unilateral 'tip-to-tip' type cervical facet locked, skull traction can safely and effectively reattach the locking cervical facet, especially for unilateral 'tip-to-tip' type (Rao et al., 2021; Hun et al., 2018; Davis et al., 1991 [7,10,11]). The following operation of ACDF alone can easily obtain satisfactory decompression of the spinal canal and stability reconstruction to the cervical spine. CONCLUSION: After successful reattachment of the locked cervical facet joint by skull traction, elective operation of ACDF was treated on the patient with single-segment cervical disc tear combined with C2-C3 transverse dislocation and unilateral 'tip-to-tip' facet locked. We found that this scheme can not only directly deal with the torn intervertebral disc, but also can effectively complete the decompression of the spinal canal and stability reconstruction of the cervical spine. The patient had a small operative incision and fewer postoperative complications. The early clinical efficacy of the patient was satisfactory.