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Conference Paper: A study of injury mechanism: traumatic bilateral L4-5 facet dislocation – case report and literature review
Title | A study of injury mechanism: traumatic bilateral L4-5 facet dislocation – case report and literature review |
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Authors | |
Issue Date | 2018 |
Publisher | The Hong Kong Orthopaedic Association. |
Citation | 38th Annual Congress of the Hong Kong Orthopaedic Association (HKOA 38), Hong Kong, 3-4 November 2018 How to Cite? |
Abstract | Introduction: Traumatic facet dislocation in the lower lumbar spine are rare, with most cases previously reported to be dislocation of lumbosacral joint (L5-S1). We present a case of young male presenting with bilateral L4-5 traumatic facet dislocation after fall injury. Possible biomechanical pathophysiology were discussed.
Methodology: PubMed was searched using search terms '(L4-5 OR L4-L5) and Traumatic spondylolisthesis OR dislocation OR locked facet OR jumped facet'
Results and Analysis: Four case reports were found in the PubMed English literature.
Discussion and Conclusion: In the four case reports, the injuries were head-on collision motor vehicle accidents. The proposed pathophysiology was an extension-distraction force. The thoracic spine and pelvis were immobilized by seatbelt, while the remaining thoracolumbar spine swung forward by momentum. Our patient fell backwards with his upper back landing onto a metal bar which acted as a fulcrum, the spine above and below was forced backwards by gravity. As a result, the spine was forced into hyperextension, and break at its weakest point. In both scenarios, there were no direct impact
force at the dislocation site, rather a hyperextension of spine occurs. Also, we have identified anatomical variants in our case which includes a more coronally aligned facet joints and the presence of L5 spina bifida. We believe that the level of injury is related to anatomical variants, and the L4-5 traumatic facet fracture dislocation and the lumbosacral dislocation should be grouped into the same disease entity. |
Description | Free Paper Session VI: Adult Spine - no. 6.19 |
Persistent Identifier | http://hdl.handle.net/10722/268342 |
DC Field | Value | Language |
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dc.contributor.author | Fok, K | - |
dc.contributor.author | Cheung, JPY | - |
dc.date.accessioned | 2019-03-18T04:23:35Z | - |
dc.date.available | 2019-03-18T04:23:35Z | - |
dc.date.issued | 2018 | - |
dc.identifier.citation | 38th Annual Congress of the Hong Kong Orthopaedic Association (HKOA 38), Hong Kong, 3-4 November 2018 | - |
dc.identifier.uri | http://hdl.handle.net/10722/268342 | - |
dc.description | Free Paper Session VI: Adult Spine - no. 6.19 | - |
dc.description.abstract | Introduction: Traumatic facet dislocation in the lower lumbar spine are rare, with most cases previously reported to be dislocation of lumbosacral joint (L5-S1). We present a case of young male presenting with bilateral L4-5 traumatic facet dislocation after fall injury. Possible biomechanical pathophysiology were discussed. Methodology: PubMed was searched using search terms '(L4-5 OR L4-L5) and Traumatic spondylolisthesis OR dislocation OR locked facet OR jumped facet' Results and Analysis: Four case reports were found in the PubMed English literature. Discussion and Conclusion: In the four case reports, the injuries were head-on collision motor vehicle accidents. The proposed pathophysiology was an extension-distraction force. The thoracic spine and pelvis were immobilized by seatbelt, while the remaining thoracolumbar spine swung forward by momentum. Our patient fell backwards with his upper back landing onto a metal bar which acted as a fulcrum, the spine above and below was forced backwards by gravity. As a result, the spine was forced into hyperextension, and break at its weakest point. In both scenarios, there were no direct impact force at the dislocation site, rather a hyperextension of spine occurs. Also, we have identified anatomical variants in our case which includes a more coronally aligned facet joints and the presence of L5 spina bifida. We believe that the level of injury is related to anatomical variants, and the L4-5 traumatic facet fracture dislocation and the lumbosacral dislocation should be grouped into the same disease entity. | - |
dc.language | eng | - |
dc.publisher | The Hong Kong Orthopaedic Association. | - |
dc.relation.ispartof | 38th Annual Congress of the Hong Kong Orthopaedic Association 2018 | - |
dc.title | A study of injury mechanism: traumatic bilateral L4-5 facet dislocation – case report and literature review | - |
dc.type | Conference_Paper | - |
dc.identifier.email | Cheung, JPY: cheungjp@hku.hk | - |
dc.identifier.authority | Cheung, JPY=rp01685 | - |
dc.identifier.hkuros | 297056 | - |
dc.publisher.place | Hong Kong | - |