Role of Anterior Approach in Management of Bilateral Cervical Locked Facet

Abstract Background: Cervical facet dislocation is the forward displacement of one cervical vertebra relative to another. Aim of Study: The aims of surgical intervention are rea-lignment and, decompression of the compressed neural struc-tures and instrumentation to stabilize the injured spine. Anterior approaches can regain normal cervical curvature and associated with little postoperative pain, better wound healing and appearance and less wound infection. Patients and Methods: A prospective study of 19 patients with bilateral cervical locked facet who underwent surgical treatment at benha university hospitals over a period of three years (Jan. 2017 / December 2019) is presented. Carefull general and neurological examination was done with preop-erative CT cervical spine as the main investigation. All cases were operated using anterior approach with the use of casper screws reduction technique to restore and stabilize the cervical curve. Results: The study group contained 16 women and 3 men. The age of patients in this study ranged from 21 years to 54 years and the mean age was 37 years. The mean follow-up period was 18 months. 15 cases presented with incomplete spinal cord injury. There were no intraoperative mortality or surgery related complications. 3 cases showed improvement while 2 cases died during follow-up due to chest problems. Conclusion: Anterior cervical decompression, reduction using casper pins elevation technique and fusion using in-tervertebral cage and plate system is very safe, effective method for the management of bilateral subaxial cervical locked facet with great success rate and very few complications in addition to familiarity to most neurosurgeons.