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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2016; 74(09): 745-749
DOI: 10.1590/0004-282X20160078
VIEWS AND REVIEWS

Surgical treatment of traumatic cervical facet dislocation: anterior, posterior or combined approaches?

Deslocamentos facetários cervicais traumáticos: abordagem anterior, posterior ou combinada?
Catarina C. Lins
1   Hospital Municipal Dr. Mário Gatti, Divisão de Neurocirurgia, Campinas SP, Brasil;
,
Diego T. Prado
2   Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Otorrinolaringologia, São Paulo SP, Brasil;
,
Andrei F. Joaquim
1   Hospital Municipal Dr. Mário Gatti, Divisão de Neurocirurgia, Campinas SP, Brasil;
3   Universidade Estadual de Campinas, Departamento de Neurologia, Campinas SP, Brasil.
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ABSTRACT

Surgical treatment is well accepted for patients with traumatic cervical facet joint dislocations (CFD), but there is uncertainty over which approach is better: anterior, posterior or combined. We performed a systematic literature review to evaluate the indications for anterior and posterior approaches in the management of CFD. Anterior approaches can restore cervical lordosis, and cause less postoperative pain and less wound problems. Posterior approaches are useful for direct reduction of locked facet joints and provide stronger fixation from a biomechanical point of view. Combined approaches can be used in more complex cases. Although both anterior and posterior approaches can be used interchangeably, there are some patients who may benefit from one of them over the other, as discussed in this review. Surgeons who treat cervical spine trauma should be able to perform both procedures as well as combined approaches to adequately manage CFD and improve patients’ final outcomes.

RESUMO

O tratamento dos deslocamentos facetários cervicais traumáticos (DFC) é preferencialmente cirúrgico, conforme a literatura pertinente, mas há dúvidas quanto a melhor forma de abordagem da coluna: anterior, posterior ou combinada. Realizamos revisão sistemática para avaliar as indicações da abordagem anterior e da posterior nos DFC. A abordagem anterior permite restaurar a lordose cervical, com menor dor no pós-operatório e menos problemas relacionados a ferida cirúrgica. A abordagem posterior permite redução direta dos deslocamentos, bem como pode resultar em uma fixação biomecanicamente mais robusta. Acessos combinados são usados em casos complexos. Embora ambas possam ser usadas, há alguns pacientes que possivelmente se beneficiem preferencialmente de uma abordagem ao invés da outra, como discutido no presente manuscrito. Cirurgiões de coluna devem ser habilitados a realizar ambos os procedimentos para melhor os resultados do tratamento dos DFC.

spine - dislocations - bones fractures - surgery
coluna vertebral - luxações - fraturas ósseas - cirurgia


Publication History

Received: 27 January 2016

Accepted: 18 April 2016

Article published online:
06 September 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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