Pediatric emergency medicine trisk 3615 3615

patients may be optimal. Neurosurgical consultation is recommended if the history
suggests a SCIWORA-type injury in a child younger than 8 years.

FIGURE 112.30 Unilateral facet dislocation. C4 is offset anteriorly on C5 less than 50% of the
width of the vertebral body. Arrows denote the offset of vertebral body and apophyseal joints.
The disc space between C4 and C5 is narrowed. Note that the distance between the posterior
cortex of the apophyseal joint facet and the anterior cortex of the spinous process tip is wider
below the level of dislocation than above the level (stars ). Anterior vertebral offset of more than
50% would denote a bilateral facet dislocation. (Reprinted with permission from Swischuk L.
Emergency Radiology of the Acutely Ill or Injured Child . 2nd ed. Baltimore, MD: Williams &
Wilkins; 1986:697.)