LAUSR

The authors present an interesting point of view of a very difficult sometimes to diagnose injury, which is the unilateral facet disclocation of the subaxial cervical spine. A model is created using cadaver head-neck-torso model after Ivancic ́s model.1 Classically the reduction of unilateral facets needs ventral flexion plus lateral bending toward the injured side to unlock the injured facet to apply then a rotation toward the affected side and then lateral bending toward the unaffected side,2 in real life the muscle spasm makes this manoeuver difficult and uncomfortable for the patient, thus the high percentage of failure, as cited by the authors. In this sense, the value of a device-controlled reduction manoeuver might be of interest. Although nevertheless the proposed reduction manoeuver is reversing the one that was previously created, in actual fact, this is not really a snag, as reduction manoeuvers are almost always devised as reversing the injuring mechanisms. My personal choice when confronted with a patient with a unilateral facet dislocation with radiculopathy and a reasonably healthy disc is a direct unilateral posterior approach with drilling of the facet to avoid any distractive force,3 anterior distractive forces are not always capable of reducing unilaterally locked facets.