Delayed Onset of Traumatic Unilateral Locked Cervical Facet: A Case Report

We present here a case of delayed onset of unilateral locked cervical facet after flexion injury. A man aged sixty-four was intoxicated with alcohol and fell from the stairs of a station striking his parietooccipital region. He complained of pain in the neck, and had difficulty with elevation of his left arm. The first radiographs of his cervical spine suggested flexion injury although these had been regarded as normal in the emergency room. He took bed rest overnight at home and returned to our hospital on the next day, not having recovered from the symptom. Further radiographs showed a right unilateral locked facet at C_4-C_5. After a failed closed reduction, an open reduction through a posterior approach, followed by anterior fusion was successful. Considering the type of cervical spine injury, particular care must be given to interpretation of radiographs. In a case of flexion injury, it is necessary to keep in mind that delayed onset of unilateral locked cervical facet may develop.