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Treatment of isolated cervical facet fractures: A systematic review

Publication ,  Journal Article
Kepler, CK; Vaccaro, AR; Chen, E; Patel, AA; Ahn, H; Nassr, A; Shaffrey, CI; Harrop, J; Schroeder, GD; Agarwala, A; Dvorak, MF; Fourney, DR ...
Published in: Journal of Neurosurgery: Spine
February 1, 2016

OBJECTIVE: In this clinically based systematic review of cervical facet fractures, the authors' aim was to determine the optimal clinical care for patients with isolated fractures of the cervical facets through a systematic review. METHODS: A systematic review of nonoperative and operative treatment methods of cervical facet fractures was performed. Reduction and stabilization treatments were compared, and analysis of postoperative outcomes was performed. MEDLINE and Scopus databases were used. This work was supported through support received from the Association for Collaborative Spine Research and AOSpine North America. RESULTS: Eleven studies with 368 patients met the inclusion criteria. Forty-six patients had bilateral isolated cervical facet fractures and 322 had unilateral isolated cervical facet fractures. Closed reduction was successful in 56.4% (39 patients) and 63.8% (94 patients) of patients using a halo vest and Gardner-Wells tongs, respectively. Comparatively, open reduction was successful in 94.9% of patients (successful reduction of open to closed reduction OR 12.8 [95% CI 6.1-26.9], p < 0.0001); 183 patients underwent internal fixation, with an 87.2% success rate in maintaining anatomical alignment. When comparing the success of patients who underwent anterior versus posterior procedures, anterior approaches showed a 90.5% rate of maintenance of reduction, compared with a 75.6% rate for the posterior approach (anterior vs posterior OR 3.1 [95% CI 1.0-9.4], p = 0.05). CONCLUSIONS: In comparison with nonoperative treatments, operative treatments provided a more successful outcome in terms of failure of treatment to maintain reduction for patients with cervical facet fractures. Operative treatment appears to provide superior results to the nonoperative treatments assessed.

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Published In

Journal of Neurosurgery: Spine

DOI

EISSN

1547-5646

ISSN

1547-5654

Publication Date

February 1, 2016

Volume

24

Issue

2

Start / End Page

347 / 354

Related Subject Headings

  • Orthopedics
  • 3209 Neurosciences
  • 1109 Neurosciences
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
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Kepler, C. K., Vaccaro, A. R., Chen, E., Patel, A. A., Ahn, H., Nassr, A., … Aarabi, B. (2016). Treatment of isolated cervical facet fractures: A systematic review. Journal of Neurosurgery: Spine, 24(2), 347–354. https://doi.org/10.3171/2015.6.SPINE141260
Kepler, C. K., A. R. Vaccaro, E. Chen, A. A. Patel, H. Ahn, A. Nassr, C. I. Shaffrey, et al. “Treatment of isolated cervical facet fractures: A systematic review.” Journal of Neurosurgery: Spine 24, no. 2 (February 1, 2016): 347–54. https://doi.org/10.3171/2015.6.SPINE141260.
Kepler CK, Vaccaro AR, Chen E, Patel AA, Ahn H, Nassr A, et al. Treatment of isolated cervical facet fractures: A systematic review. Journal of Neurosurgery: Spine. 2016 Feb 1;24(2):347–54.
Kepler, C. K., et al. “Treatment of isolated cervical facet fractures: A systematic review.” Journal of Neurosurgery: Spine, vol. 24, no. 2, Feb. 2016, pp. 347–54. Scopus, doi:10.3171/2015.6.SPINE141260.
Kepler CK, Vaccaro AR, Chen E, Patel AA, Ahn H, Nassr A, Shaffrey CI, Harrop J, Schroeder GD, Agarwala A, Dvorak MF, Fourney DR, Wood KB, Traynelis VC, Yoon ST, Fehlings MG, Aarabi B. Treatment of isolated cervical facet fractures: A systematic review. Journal of Neurosurgery: Spine. 2016 Feb 1;24(2):347–354.

Published In

Journal of Neurosurgery: Spine

DOI

EISSN

1547-5646

ISSN

1547-5654

Publication Date

February 1, 2016

Volume

24

Issue

2

Start / End Page

347 / 354

Related Subject Headings

  • Orthopedics
  • 3209 Neurosciences
  • 1109 Neurosciences
  • 1103 Clinical Sciences