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

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

Author information

1
Department of Orthopaedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.
2
Department of Orthopaedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong SAR, China. cheungjp@hku.hk.

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

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