Impact of a Comprehensive Physiotherapy on a Complex Case of Locked Facet Joint: A Case Report
Keywords:Facet Joint Lock, Pain, Stiffness and Manual Manipulations.
Introduction -Locked facet joint is a type of facet joint dislocation which occurs due to jumping of the
inferior articular process over the superior articular process of the vertebra below and causes locking in
that position. It can be unilateral or bilateral. In case of unilateral facet joint locking mechanism is flexion/
distraction and rotation. Only 30% of cases associated with neurologic defect. Most often it occurs at C4-5
and C5-6 level. Inferior articular facet of superior vertebral body is locked in front of the superior facet
of the more inferior vertebral body but only on one side. X-ray Image Findings in such cases are - subtle,
slight anterior subluxation of one vertebral body on the one below usually less than 25% of the width. On
lateral view of cervical spine, some bodies appear true lateral below level of injury and oblique above level
of injury that is the “Bow-tie sign”. Spinous processes do not align on frontal film. Spinous processes of
inferior vertebrae displace toward the locked side. In case of bilateral facet joint locking there is always
a history of severe flexion injury. Both anterior and posterior ligamentous structures are disrupted at site
of injury. More superior vertebra subluxes forward by 50% or more of the body below. Usually occurs in
lower cervical spine. Generally, facet locking is a rare occurrence. Case Description – a case of 43 years
old female is presented in the report who presented with pain and stiffness in neck which was sudden in
onset was present since last two days. Assessment, patient’s history and treatment have been discussed in the
case study. Conclusion – This case study concluded that there is a significant effect of the given therapeutic
intervention on pain, range of motion and activities of daily living (ADL) of the patient.
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