Treatment of Isolated “Floating Lateral Mass” Fractures of the Cervical Spine: A Case Series
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Abstract
Materials and Methods: We conducted a descriptive and retrospective study on a case series of isolated floating lateral mass facet fractures diagnosed between January 1, 2016 and January 1, 2022. Patients with floating lateral mass lesions according to the AO classification, diagnosed by computed tomography, and at least 6 months of follow-up were included. Patients with pathological fractures, bone fragility injuries and incomplete records were excluded.
Results: We included 16 cases, the average age was 42.86 (SD 12.396), and the majority were male (n=13; 81.25%). 68.75% (n=11) had intervertebral disc injury in the fractured segment, while 18.75% (n=3) had anterolisthesis. Conservative treatment was proposed for 12 weeks in 11 patients (68.75%), of whom 5 (45.4%) achieved fracture healing and 6 (54.6%) progressed to translation. Cases where conservative treatment failed were associated with intervertebral disc injury. Eleven patients were treated surgically, mostly with monosegmental anterior cervical arthrodesis.
Conclusions: We report a series of cases in which the existence of an associated intervertebral disc injury was more frequent in patients with failed conservative treatment and in those initially treated with arthrodesis. Most of the surgical cases were treated using an anterior approach with discectomy and anterior cervical arthrodesis at a single level, with favorable outcomes.
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References
facet fractures in the cervical spine: a prospective case series and biomechanical analysis. Int J Spine Surg 2018;12(1):85-91. https://doi.org/10.14444/5014
2. Pehler S, Jones R, Staggers JR, Antonetti J, McGwin G, Theiss SM. Clinical outcomes of nonoperatively treated
cervical facet fractures with rigid collar immobilization or halo immobilization. Global Spine J 2019;9(1):48-54.
https://doi.org/10.1177/2192568218771911
3. Vaccaro AR, Koerner JD, Radcliff KE, Oner FC, Reinhold M, Schnake KJ, et al. AOSpine subaxial cervical spine
injury classification system. Eur Spine J 2016;25(7):2173-84. https://doi.org/10.1007/s00586-015-3831-3
4. Manoso MW, Moore TA, Agel J, Bellabarba C, Bransford RJ. Floating lateral mass fractures of the cervical spine.
Spine (Phila Pa 1976) 2016;41(18):1421-7. https://doi.org/10.1097/BRS.0000000000001536
5. Larkin CJ, Abecassis ZA, Yerneni K, Nistal DA, Karras CL, Greg Frankel H, et al. Surgical versus conservative
treatment of non-subluxed unilateral subaxial facet fractures: a systematic review and meta-analysis. Clin Neurol
Neurosurg 2020;199:106280. https://doi.org/10.1097/BRS.0000000000001536
6. Totera JIC, Vargas GH, Martini IF, Romero MG, Bacciarini AU, Plaza JVB. Unilateral cervical facet fractures:
Relevance of acute disc injury in conservative treatment failure. Asian Spine J 2023;17(1):30-6.
https://doi.org/10.31616/asj.2021.0437
7. Caravaggi P, Chen L, Uko L, Zorrilla A, Hauser S, Vives MJ. Kinematics of the cervical spine after unilateral facet
fracture: an in vitro cadaver study. Spine (Phila Pa 1976) 2017;42:E1042-9. https://doi.org/10.1097/BRS.0000000000002080
8. Kirshblum SC, Biering-Sorensen F, Betz R, Burns S, Donovan W, Graves DE, et al. International Standards for Neurological Classification of Spinal Cord Injury: cases with classification challenges. J Spinal Cord Med 2014;37(2);120-7. https://doi.org/10.1179/2045772314Y.0000000196
9. Vedantam A, Fridley JS, Navarro JC, Gopinath SP. Management of acute unilateral nondisplaced subaxial cervical facet fractures. Oper Neurosurg (Hagerstown) 2018;14:104-11. https://doi.org/10.1093/ons/opx069
10. Prezelski K, Simon KN, Nwadike BA, Place HM. Assessing treatment of floating lateral mass (FLM) fractures of
the subaxial cervical spine. Spine (Phila Pa 1976) 2023 Apr 28. https://doi.org/10.1097/BRS.0000000000004697