Perched facet joint

Last revised by Raymond Chieng on 1 Jun 2023

Perched facet joint is a vertebral facet joint whose inferior articular process appears to sit 'perched' on the ipsilateral superior articular process of the vertebra below.

Any further anterior subluxation will result in dislocation, with one facet "jumping" over the other and becoming locked in this position (see jumped facet joint). 

Unilateral perched facet results from hyperflexion, lateral compression, and rotation of the cervical spine in motor vehicular accident 6. Perched bilateral facets are also possible.

  • malalignment of the lateral masses

  • the tips of adjacent facets touch each other i.e. inferior articular process of a vertebra appears to sit 'perched' on the superior articular process of the vertebra below

  • distracted facet with uncovering of the articular surface

  • spinal cord injury, especially with bilateral involvement, or in the setting of canal stenosis

  • vertebral artery injury, e.g. dissection, thrombosis

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