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The surgical treatment of subaxial acute cervical spine facet dislocations in adults: a systematic review and meta-analysis

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Abstract

Adult cervical spine traumatic facet joint dislocations occur when excessive traumatic forces displace the vertebrae’s facets, leading to loss of joint congruence. Reduction requires either cranial traction or open surgical procedures. This study aims to appraise the effects of different surgical techniques in the treatment of subaxial cervical spine acute traumatic facet blocks in adults. This study was based on a systematic literature review and meta-analysis, registered in Prospero (CRD42021279249). The PICO question was composed of adults with acute cervical spine traumatic facet dislocations submitted to anterior or posterior surgical approaches, associated or not with cranial traction for reduction. Each surgical technique was compared to the other. The primary clinical outcomes included neurological improvement or worsening and surgical success/failure rates. The anterior approach without cranial traction was efficient in reducing facet displacements. Skull traction was an efficient and immediate method to achieve spine dislocation reductions. Differences were not present among techniques regarding neurological improvement. There were no surgical failures in patients operated on via the posterior approach. The need to decompress and stabilize the cervical spine can be achieved by anterior or posterior surgical approaches, and there is no clear answer as to which initial approach is superior to the other.

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Authors and Affiliations

  1. Hospital Do Servidor Público Estadual de São Paulo, São Paulo, Brazil

    Ricardo Vieira Botelho & Eduardo de Freitas Bertolini

  2. Division of Neurosurgery, University Hospital Lauro Wanderley/UFPB, João Pessoa, Paraíba, Brazil

    Alécio Cristino Evangelista Santos Barcelos

  3. School of Medical Sciences, Santa Casa de São Paulo, São Paulo, Brazil

    Jefferson Walter Daniel

  4. Department of Neurosurgery, UNICAMP, Campinas, São Paulo, Brazil

    Andrei Fernandes Joaquim

  5. Biocor Instituto, Belo Horizonte, Minas Gerais, Brazil

    Fernando Luiz Rolemberg Dantas & François Dantas

  6. Department of Neurosurgery, Federal University of São Paulo, São Paulo, Brazil

    Franz Onishi

  7. Department of Neurosurgery, University of São Paulo, São Paulo, Brazil

    Eloy Rusafa Neto

  8. Universidade Cruzeiro Do Sul, São Paulo, Brazil

    Marcelo Luiz Mudo

  9. Brazilian Neurosurgical Society’s Spine Department, Neurological Institute of Curiritba, Curitiba, Paraná, Brazil

    Jerônimo Buzetti Milano

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  1. Ricardo Vieira Botelho
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Contributions

Conception and design: all the authors participated. Material preparation, data collection, and analysis were performed by Ricardo Botelho, Eduardo Bertolini, Alécio Barcelos, Jefferson Daniel, and Andrei Joaquim. Material preparation, data collection, and analysis were performed by Fernando Dantas, François Dantas, Franz Onishi, Eloy Rusafa Neto, Marcelo Luiz Mudo, and Jerônimo Milano. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Ricardo Vieira Botelho.

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Botelho, R.V., de Freitas Bertolini, E., Barcelos, A.C.E.S. et al. The surgical treatment of subaxial acute cervical spine facet dislocations in adults: a systematic review and meta-analysis. Neurosurg Rev 45, 2659–2669 (2022). https://doi.org/10.1007/s10143-022-01808-1

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  • DOI: https://doi.org/10.1007/s10143-022-01808-1

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