Chronic unilateral locked facet joint with spinal cord injury in a 26-month-old child: A case report

The Journal of Spinal Cord Medicine, 2015 · DOI: 10.1179/2045772314Y.0000000204 · Published: January 1, 2015

Spinal Cord Injury Pediatrics Research Methodology & Design

Simple Explanation

This case report discusses a rare condition in a young child involving a locked facet joint in the neck, leading to spinal cord injury. The usual treatments may not be effective in chronic cases, necessitating surgical intervention. The child initially presented with leg weakness, which was misattributed to a leg fracture, delaying the diagnosis of the spinal issue. This delay highlights the challenges in diagnosing such conditions in young children. Surgery was performed to correct the locked joint and stabilize the spine. Post-operative care included external fixation with a plaster cast and rehabilitation exercises to regain limb function.

Study Duration

1 year

Participants

A 26-month-old girl

Evidence Level

Level IV: Case Report

Key Findings

1
The surgical reduction and fusion of the C4/5 vertebrae were successful in a 26-month-old child with a chronic unilateral locked facet joint and spinal cord injury.
2
Bone fusion was achieved three months post-surgery, and the patient's lower limb function improved one year after surgery with physical rehabilitation.
3
Non-surgical treatments may not be suitable for chronic cases of unilateral locked facet joint with spinal cord injury, indicating the need for surgical intervention in such scenarios.

Research Summary

This case report describes the successful surgical management of a 26-month-old child with a chronic unilateral locked facet joint and spinal cord injury (SCI). The child underwent posterior surgical reduction and fusion, followed by plaster external fixation and rehabilitation exercises. Bone fusion was achieved, and lower limb function improved. The authors conclude that while non-surgical treatment is preferred for acute cases, surgical intervention may be necessary for chronic cases with SCI.

Practical Implications

Diagnostic Awareness

Clinicians should consider cervical spine injuries in pediatric patients presenting with limb weakness, even in the presence of other apparent injuries.

Surgical Intervention

Surgical intervention should be considered for chronic unilateral locked facet joints with SCI in pediatric patients when non-surgical methods fail.

Long-Term Monitoring

Long-term follow-up is necessary to monitor for potential complications like cervical kyphosis and adjacent segment degeneration after posterior fixation and fusion.

Study Limitations

1
The study is a single case report, limiting the generalizability of the findings.
2
Lack of long-term follow-up data to assess the durability of the surgical correction and the development of potential complications.
3
The rarity of this condition limits the availability of clinical experiences and evidence-based guidelines for management.

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