Cervical Traumatic Deformity (Bilateral Facet Dislocation) Complication

Traumatic bilateral facet dislocation is rare but is associated with high-grade neurological injuries. The typical mechanism is isolated hyperflexion without rotation and results in disruption of the posterior ligamentous complex but can also be accompanied by anterior longitudinal ligament disruption with grossly unstable motion segment. Closed reduction with Gardner-Wells tongs and traction is the most common first-line intervention in the United States. MRI is not needed prior to closed reduction unless the patient cannot be examined because of altered mental status or when closed reduction has failed prior to either anterior or posterior surgical procedures. Potential options and precautions to treat and prevent complications associated with inadequate resuscitation and manual reduction are described.