Vertebral Artery Occlusion and Recanalization After Cervical Facet Dislocation

OBJECTIVE: To investigate clinical features of vertebral artery (VA) occlusion and recanalization after cervical facet dislocation. METHODS: During a 2-year period from January 2014 to December 2015, 29 consecutive patients with cervical facet dislocation were treated in investigator group. VA occlusion and recanalization were identified retrospectively by magnetic resonance imaging (MRI) at the time of injury and follow-up. RESULTS: VA occlusion occurred in 6 of the 29 patients (20.7%). All patients were unilateral occlusion and had no vertebrobasilar symptoms. Surgical anterior spinal fusion was performed in 5 patients, and 1 was treated by posterior fusion. Follow-up MRIs revealed VA recanalization in 5 patients. One patient did not undergo MRI because he died of respiratory failure. The time course for VA recanalization was from 6 days after injury to 4 months after operation depending on the length of VA occlusion. CONCLUSIONS: A fifth of patients with cervical facet dislocation will develop VA occlusion with rare symptomatic vertebrobasilar ischemia. VA recanalization occurs mainly within the first 4 months after injury, regardless of the length of VA occlusion.