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Spine Case 2 History/Physical Exam

Facet Dislocation

History and Physical Exam


  • Flexion-distraction
  • Additional rotational component postulated for unilateral dislocations


  • MVCs
  • Falls from significant height
  • In elderly patients, possibly only relatively minor trauma.

Unilateral facet dislocation presentation:

  • Head often held deviated away from the side of the injury
  • Pain with inability to straighten the head
  • Ipsilateral radiculopathy
  • Possibly palpable malalignment of spinous processes

Bilateral facet dislocation presentation:

  • Neck pain often with frank neurologic deficit
  • Possibly palpable bony stepoff