Treatment of unilateral L5–S1 locked facet in a pediatric patient

Abstract

Background: Traumatic unilateral lumbosacral facet dislocations are rare injuries. The majority of cases are treated with open reduction and instrumented spinal fusions. Only less commonly can they be managed conservatively. Case Description: A 7-year-old unrestrained passenger was involved in a high-speed motor vehicle accident. X-ray/magnetic resonance/computed tomography imaging documented a unilateral L5–S1 facet dislocation and multiple lumbar/sacral fractures. The patient underwent open reduction and temporary L5-pelvic instrumentation without fusion; the instrumentation was removed 10 weeks later at which point follow-up imaging showed preserved lumbosacral stability. Conclusion: Open reduction with temporary instrumentation without fusion was successfully utilized to treat a unilateral L5–S1 facet dislocation in a 7-year-old child.