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Spine Case 2 ED Management

Facet Dislocation

ED Management


  • Hard collar if possible.
  • Do not force into a collar if spine is locked.
  • Instead use sandbags, towel rolls, and tape.

Closed reduction by spine specialist (often in the ED):

  • Halo device


  • Gardner-Wells tongs. This involves placing a traction device into the skull and increasing hanging weights at 15 minute intervals until serial radiographs document reduction.
  • Neurologic deficit may worsen after closed reduction (from disc protrusion), so serial neurologic exams are crucial.

These injuries are usually subsequently managed operatively.