Unilateral facet dislocations: Is surgery really the preferred option?
Bibliographic record
Abstract
STUDY DESIGN: Systematic review. OBJECTIVE: To compare the safety and effectiveness of initial surgery versus nonoperative management of unilateral facet dislocations with or without fractures. SUMMARY OF BACKGROUND: Unilateral facet injuries represent between 6%-10% of all cervical spine injuries and yet optimal treatment for these injuries has not been established. The surgeon is faced with the decision of whether to manage the injury operatively or nonoperatively. Providing evidence to support this decision is necessary and is the rationale behind this article. METHODS: A systematic review of the English language literature was undertaken for articles published between 1970 and August 2009. Electronic databases and reference lists of key articles were searched to identify studies evaluating surgery and nonoperative management of unilateral facet dislocations. Bilateral facet dislocations, isolated facet fractures (without dislocation), and complete spinal cord injuries were excluded. Two independent reviewers assessed the level of evidence quality using the GRADE criteria and disagreements were resolved by consensus. RESULTS: We identified six articles meeting our inclusion criteria. Treatment failure, neurological deterioration, and persistent pain occurred more frequently in patients treated nonoperatively versus patients treated with surgery. Surgical patients experienced infections and surgical related complications not experience by those managed nonoperatively. Patients treated surgically after failed nonoperative management also experienced better outcomes than those who continued to be managed nonoperatively. CONCLUSION: When faced with a patient requesting treatment recommendations for their acute unilateral facet dislocation, the surgeon can state that treatment failure, persistent pain, and neurological deterioration occur more frequently with nonoperative treatment based on the available literature. Ultimately it will be the preference of the patient that will decide between these two treatment approaches.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".