Rare Case of Bilateral Pure Facet Joint Dislocation of Upper Lumbar Spine without Facet Fracture: A Case Report

INTRODUCTION: Bilateral facetal dislocation without facet fracture, although common in cervical spine, is a very rare entity in lumbar spine with <15 cases reported so far. Such injuries are very unstable involving all the three columns. Neurological insult and visceral affection are commonly associated with bilateral facetal dislocation. CASE REPORT: A 22-year-old gentleman presented with ASIA Aparaplegia following road traffic accident. Radiographs/computed tomography scan revealed pure facetal dislocation L1-L2 with no evidence of facet fracture. The patient also had liver laceration. The patient underwent open instrumented reduction along with left-sidedtransforaminal removal of damaged disc and inter body fusion. The patient improved significantly to ASIA C neurological status at 6-month follow-up. CONCLUSION: Pure facetal dislocation, although rarely seen in lumbar region, is a very unstable injury. Prompt recognition and early intervention facilitate nursing care and neurological recovery. Recognition of associated injuries is also important.