Bilateral facet to spinous process fusion: A new technique for posterior spinal fusion after trauma

A variety of options exist for the treatment of fracture/dislocation of the cervical spine, including prolonged traction immobilization, immobilization in an external device, and open surgical fusion. In cases of facet dislocation and flexion/compression injuries, the authors have found that surgical fusion is the most useful. However, in cases of facet fracture or disruption of the posterior neural arch, routine interspinous wiring techniques do not provide adequate rotational stability and may allow postsurgical redislocation before bony fusion. For these cases, a new technique using bilateral facet to spine wire loops has been developed. In the 25 cases reported here, the technique provided excellent stability against anterior horizontal displacements and rotational dislocations despite unilateral or bilateral facet fracture or disruption of the posterior neural arch.