Traumatic bilateral L4-5 facet fracture dislocation: a case presentation with mechanism of injury

BMC Musculoskelet Disord. 2019 Nov 23;20(1):558. doi: 10.1186/s12891-019-2921-5.

Abstract

Background: Traumatic bilateral locked facet joints at L4-5 level are a rare entity. A careful review only revealed four case reports. This case presented with an unusual mechanism of injury.

Case presentation: We present a case of a 40-year-old male who suffered bilateral L4-5 traumatic facet fracture dislocation following a fall injury. The dislocation was associated with fractures of bilateral L4 inferior articular processes, left L4 pedicle, L4 spinous process and postero-inferior body of L4. He presented with cauda-equina syndrome and underwent emergency decompression, reduction and instrumented fusion.

Conclusion: The biomechanics of the lumbar spine may differ with each individual. L4-5 dislocation may be a variant to lumbosacral (L5-S1) dislocation, owing to hyperextension injury.

Keywords: Jumped facet; L4–5; Locked facet; Traumatic spondylolisthesis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Fracture Fixation, Internal / instrumentation
  • Fracture Fixation, Internal / methods*
  • Humans
  • Joint Dislocations / complications
  • Joint Dislocations / diagnostic imaging
  • Joint Dislocations / surgery*
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / surgery*
  • Male
  • Spinal Fractures / complications
  • Spinal Fractures / diagnostic imaging
  • Spinal Fractures / surgery*