Northwestern University Feinberg School of Medicine

Orthopedic Teaching

Spine Case 2 History/Physical Exam

Facet Dislocation


History and Physical Exam

Mechanism:

  • Flexion-distraction
  • Additional rotational component postulated for unilateral dislocations

History:

  • MVCs
  • Falls from significant height
  • In elderly patients, possibly only relatively minor trauma.

Unilateral facet dislocation presentation:

  • Head often held deviated away from the side of the injury
  • Pain with inability to straighten the head
  • Ipsilateral radiculopathy
  • Possibly palpable malalignment of spinous processes

Bilateral facet dislocation presentation:

  • Neck pain often withfrank neurologic deficit
  • Possibly palpable bony stepoff