Supplementary Material for: Traumatic C6-C7 fracture-dislocation with surgical correction of anterior hardware fusion failure and neglected locked facet: case report and literature review

Background: ​​The cervical spine represents the most common site of spinal trauma, typically associated with vertebrae dislocation with locked facets. Accurate assessment of the entire spine is essential to prevent diagnostic and therapeutic failures. Here, we present a case of a patient with C6–C7 dislocation who underwent two unsuccessful surgical procedures, highlighting the technical challenges associated with revision surgery and persistent facet locking. Case description: A 26-year-old male arrived at an emergency hospital after a motorcycle accident with paraplegia, C6 roots strength grade 2, and C7, C8, and T1 paralysis. The cervical computed tomography scan revealed C6-C7 dislocation, left C7-T1 locked facet, and right C6-C7 facet subluxation. After two unsuccessful surgical procedures, a combined 540-degree P-A-P approach was performed. After the combined P-A-P cervical spine approach, the patient remained paraplegic, with no further neurological deterioration during follow-up. Conclusion: Early diagnosis and management of locked facets is crucial to avoid unstable constructions and subsequently hardware failure in patients with cervical spinal trauma.Background: 颈椎是脊柱创伤最常见的受累部位，此类创伤多伴有关节突交锁的椎体脱位。对全脊柱进行精准评估，是规避诊断与治疗失误的核心前提。本文报告1例C6-C7椎体脱位患者，该患者先后接受2次手术均未获成功，以此凸显翻修手术与持续性关节突交锁所伴随的技术挑战。 Case description: 1例26岁男性患者因摩托车交通事故送至急诊医院，入院时存在截瘫症状，C6神经根肌力为2级，C7、C8及T1神经根麻痹。颈椎计算机断层扫描（computed tomography，CT）检查显示C6-C7椎体脱位、左侧C7-T1关节突交锁及右侧C6-C7关节突半脱位。在两次手术均失败后，为该患者实施了联合540°后-前-后（posterior-anterior-posterior，P-A-P）入路手术。接受该联合P-A-P颈椎入路术后，患者仍维持截瘫状态，随访期间未出现神经功能进一步恶化。 Conclusion: 颈椎创伤患者早期诊断并处理关节突交锁，对于避免内固定结构不稳及后续内置物失效至关重要。