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a) Computed tomography (CT) images showing left facet dislocation at C4-C5. b) Three-dimensional CT reconstruction of the cervical spines, showing a dilated interlaminar space. c) Magnetic resonance images showing spinal cord compression at C4-C5 on T2 STIR-weighted sequence with no obvious disc herniation.
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American Spinal Injury Association impairment scale (Fig. 1). An attempt to perform closed reduction with halo crown traction under mild sedation immediately after transfer to the hospital was unsuccessful.
a, b) Schematic illustration of the posterior percutaneous reduction with an elevator. c) Fluoroscopic image after percutaneous reduction with an elevator. d) Radiograph after reduction showing 18 -kyphosis and a dilated interspinous space at C4-C5.
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An elevator was inserted into the locked facet percutaneously through a small incision above the facet with fluoroscopic assistance, and reduction was achieved by lever action without complications (Fig. 2).
Anteroposterior (a) and lateral (b) radiographs 3 months after ACDF showing complete bony union and 4 -lordosis.
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The postoperative cervical alignment was optimal, and complete bony union was achieved (Fig. 3).