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Dynamic posterior stabilization for traumatic lumbar facet fracture: A case report

Year: 2026

Type: article

Abstract: This case report describes an 18-year-old woman who presented after a high-speed motor vehicle collision with a large displaced right L5 superior facet fracture, noted to be neurologically intact. She sustained multiple associated injuries, including small-bowel trauma with hemoperitoneum requiring exploratory laparotomy and double enterectomy. Following a trial of conservative management with thoracolumbosacral orthosis (TLSO), upright radiographs demonstrated progressive L4-5 coronal and sagittal deformity with facet distraction, her neurologic examination remained normal throughout follow-up. Given her age and the concern for adjacent-segment disease with fusion, we proceeded with total posterior spine (TOPS) arthroplasty at the level of L4-L5. Surgery included laminectomy, bilateral complete facetectomies, pedicle-screw instrumentation, and TOPS implantation. The postoperative course was uncomplicated, with intact neurology and progressive improvement in mobility. This case describes the novel utilization of motion-preserving posterior arthroplasty in traumatic facet injury, allowing for deformity correction while potentially minimizing the long-term morbidity associated with lumbar fusion.

Source: North American Spine Society Journal (NASSJ)

DOI: 10.1016/j.xnsj.2026.100852

Authors: Allison Kelliher, Tan Chen

Institutions: Geisinger Wyoming Valley Medical Center, Inova Health System

Language: English

Topic: Spinal Fractures and Fixation Techniques

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,950