Question 1: Compare the safety and efficacy of initial surgery versus nonoperative management of unilateral facet dislocations.
Outcomes | Strength of evidence | Conclusions/comments |
---|---|---|
1. Treatment failure | ![]() |
Treatment failure rates are higher in nonoperatively managed patients compared to surgically managed patients. |
2. Neurological deterioration | ![]() |
Neurological deterioration happened infrequently, but occurred more frequently in nonoperative treatment versus operative treatment. |
3. Wound or surgical infection | ![]() |
Rate of infection ranged from 0%–12% in surgically managed patients. |
4. Posttreatment pain | ![]() |
Long term persistent pain occurred more frequently in nonoperative treatment compared to operative treatment. |
5. Complications | ![]() |
Complication rates occurred at a mean of 13.8% in surgically managed patients. |
Details about the determination of strength of evidence can be found in the web appendix at www.aospine.org/ebsj