Case Report
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Year 2021, , 431 - 436, 31.12.2021

Halil Can Küçükyıldız , Mustafa Karademir , Giray Güneş Ünal Özüm

https://doi.org/10.7197/cmj.981538

Abstract

References

  • 1] Schneider RC, Livingston KE, Cave AJ, et al. “Hangman’s fracture” of the cervical spine. J Neurosurg. 1965;22:141–154.
  • [2] Effendi B, Roy D, Cornish B, Dussault RG, Laurin CA: Fractures of the ring of the axis: A classification based on the analysis of 131 cases. J Bone Joint Surg Br 63B:319–327, 1981
  • [3] Murphy H, Schroeder GD, Shi WJ, Kepler CK, Kurd MF, Fleischman AN, et al. Management of Hangman’s fractures: a systematic review. J Orthop Trauma 2017;31(Suppl 4):S90–5.
  • [4] Levine AM, Edwards CC: The management of traumatic spondylolisthesis of the axis. J Bone Joint Surg Am 67A:217– 226, 1985
  • [5] X.F. Li, L.Y. Dai, H. Lu, X.D. Chen, A systematic review of the management of hangman’s fractures, Eur. Spine J. 15 (3) (2006) 257–269.
  • [6] J.J. Shin, S.H. Kim, Y.E. Cho, S.H. Cheshier, J. Park, Primary surgical management by reduction and fixation of unstable hangman’s fractures with discoligamentous instability or combined fractures: clinical article, J. Neurosurg. Spine 19 (5) (2013) 569–575.
  • [7] Leconte P. Fracture et luxation des deux premières vertèbres cervicales. In: Judet R, editor. Luxation Congenénitale de la Hanche: Fractures du Cou-de-pied Rachis Cervical. Actualités de Chirurgie Orthopédique de l’Hö pital Raymond-Poincaré. Paris: Masson et Cie; 1964. pp. 147–166
  • [8] Benzel EC, Lancon J, Kesterson L, et al. Cervical laminectomy and dentate ligament section for cervical spondylotic myelopathy. J Spinal Disord 1991; 4:286–95.
  • [9] Wewers ME, Lowe NK. A critical review of visual analogue scales in the measurement of clinical phenomena. Research in Nursing & Health 13: 227-236, 1990.
  • [10] Borne GM, Bedou GL, Pinaudeau M. Treatment of pedicular fractures of the axis. A clinical study and screw fixation technique. J Neurosurg. 1984;60:88–93. doi: 10.3171/jns. 1984.60.1.0088.
  • [11] Vaccaro AR, Madigan L, Bauerle WB, Blescia A, Cotler JM. Early halo immobilization of displaced traumatic spondylolisthesis of the axis. Spine. 2002;27(20):2229–2233. doi: 10.1097/00007632-200210150-00009.
  • [12] Özer AF, Çerçi A, Sasani M, Kalelioğlu M, Sarıoğlu AÇ, Posterior screw-plate fixation in traumatic spondylolisthesis of axis, Turkish Journal Of Trauma and Emergency Surgery. (1999); 5(4): 288-291
  • [13] ElMiligui Y, Koptan W, Emran I. Transpedicular screw fixation for type II Hangman's fracture: a motion preserving procedure. Eur Spine J. 2010;19(8):1299-1305. doi:10.1007/s00586-010-1401-
  • [14] Liu, Y., Zhu, Y., Li, X. et al. A new transpedicular lag screw fixation for treatment of unstable Hangman’s fracture: a minimum 2-year follow-up study. J Orthop Surg Res 15, 372 (2020). https:// doi.org/10.1186/s13018-020-01911-3
  • [15] Muller EJ, Wick M, Muhr G. Traumatic spondylolisthesis of the axis: treatment rationale based on the stability of the different fracture types. Eur Spine J. 2000;9:123–128. doi: 10.1007/ s005860050222.
  • [16] Verheggen R, Jansen J. Hangman’s fracture: arguments in favor of surgical therapy for type II and III according to Edwards and Levine. Surg Neurol. 1998;49(3):253–261. doi: 10.1016/ S0090-3019(97)00300-5.
  • [17] Rajasekaran S, Vidyadhara S, Shetty AP. Iso-C3D fluoroscopy-based navigation in direct pedicle screw fixation of Hangman fracture: a case report. J Spinal Disord Tech. 2007;20(8):616–619. doi: 10.1097/BSD.0b013e318074f978.
  • [18] Roy-Camille R, Saillant G, Mazel C. Internal fixation of the unstable cervical spine by a posterior osteosynthesis with plats and screws. In: The Cervical Spine Research Society, editor. The cervical spine. 2. Philadelphia: Lippincott Williams & Wilkins; 1989. pp. 390–403.
  • [19] Salunke P, Sahoo SK, Krishnan P, Chaterjee D, Sodhi HB. Are C2 pars-pedicle screws alonefor type II Hangman’s fracture overrated? Clin Neurol Neurosurg 2016;141:7–12.

C2 transpedicular fixation technique in Hangman's Fracture

Year 2021, , 431 - 436, 31.12.2021

Halil Can Küçükyıldız , Mustafa Karademir , Giray Güneş Ünal Özüm

https://doi.org/10.7197/cmj.981538

Abstract

Objective : Traumatic spondylolisthesis of the axis, also known as hangman fractures, all cervical it accounts for 4-7% of all traumas and is the second most common axis after odontoid fractures. trauma. There are unstable fractures and the treatment options are immobilization with halo or surgery.
is stabilization. By most authors, it is primarily associated with halo in patients with Type 1 and Type 2 fractures.Although external fixation and immobilization are recommended, halon is a difficult orthosis to use.
Because of this, segmental motion sparing surgery provides rapid recovery in suitable patients may be an option. In the case we presented, the treatment approach in Hangman's fractures was reviewed in the literature.
has been reviewed and discussed.
Clinical Presentation: Our case, after AITC, with Levin Edwards Type 1A Hangman fracture, A 40-year-old female patient with no neurological deficits. The patient does not prefer to use a halo orthosis C2 transpedicular surgery was performed with a lag screw for motion-sparing surgery to a young patient fixation is planned.
Technique: C2 transpedicular lag screw was applied to the patient with intraoperative fluoroscopy.
Conclusion: C2 transpedicular fixation with Lag screw, according to posterior segmental stabilization a more minimally invasive and motion-sparing surgery, faster recovery time may be preferred to traditional posterior stabilization methods in selected patient groups due to The patient who did not prefer the use of orthoses due to the social disadvantages of immobilization with Halo it is a quick and cost-effective surgical option in groups with a rapid recovery time.

Keywords

Hangman's fracture c2 transpedicular fixation traumatic spondylolistesis of axis

References

  • 1] Schneider RC, Livingston KE, Cave AJ, et al. “Hangman’s fracture” of the cervical spine. J Neurosurg. 1965;22:141–154.
  • [2] Effendi B, Roy D, Cornish B, Dussault RG, Laurin CA: Fractures of the ring of the axis: A classification based on the analysis of 131 cases. J Bone Joint Surg Br 63B:319–327, 1981
  • [3] Murphy H, Schroeder GD, Shi WJ, Kepler CK, Kurd MF, Fleischman AN, et al. Management of Hangman’s fractures: a systematic review. J Orthop Trauma 2017;31(Suppl 4):S90–5.
  • [4] Levine AM, Edwards CC: The management of traumatic spondylolisthesis of the axis. J Bone Joint Surg Am 67A:217– 226, 1985
  • [5] X.F. Li, L.Y. Dai, H. Lu, X.D. Chen, A systematic review of the management of hangman’s fractures, Eur. Spine J. 15 (3) (2006) 257–269.
  • [6] J.J. Shin, S.H. Kim, Y.E. Cho, S.H. Cheshier, J. Park, Primary surgical management by reduction and fixation of unstable hangman’s fractures with discoligamentous instability or combined fractures: clinical article, J. Neurosurg. Spine 19 (5) (2013) 569–575.
  • [7] Leconte P. Fracture et luxation des deux premières vertèbres cervicales. In: Judet R, editor. Luxation Congenénitale de la Hanche: Fractures du Cou-de-pied Rachis Cervical. Actualités de Chirurgie Orthopédique de l’Hö pital Raymond-Poincaré. Paris: Masson et Cie; 1964. pp. 147–166
  • [8] Benzel EC, Lancon J, Kesterson L, et al. Cervical laminectomy and dentate ligament section for cervical spondylotic myelopathy. J Spinal Disord 1991; 4:286–95.
  • [9] Wewers ME, Lowe NK. A critical review of visual analogue scales in the measurement of clinical phenomena. Research in Nursing & Health 13: 227-236, 1990.
  • [10] Borne GM, Bedou GL, Pinaudeau M. Treatment of pedicular fractures of the axis. A clinical study and screw fixation technique. J Neurosurg. 1984;60:88–93. doi: 10.3171/jns. 1984.60.1.0088.
  • [11] Vaccaro AR, Madigan L, Bauerle WB, Blescia A, Cotler JM. Early halo immobilization of displaced traumatic spondylolisthesis of the axis. Spine. 2002;27(20):2229–2233. doi: 10.1097/00007632-200210150-00009.
  • [12] Özer AF, Çerçi A, Sasani M, Kalelioğlu M, Sarıoğlu AÇ, Posterior screw-plate fixation in traumatic spondylolisthesis of axis, Turkish Journal Of Trauma and Emergency Surgery. (1999); 5(4): 288-291
  • [13] ElMiligui Y, Koptan W, Emran I. Transpedicular screw fixation for type II Hangman's fracture: a motion preserving procedure. Eur Spine J. 2010;19(8):1299-1305. doi:10.1007/s00586-010-1401-
  • [14] Liu, Y., Zhu, Y., Li, X. et al. A new transpedicular lag screw fixation for treatment of unstable Hangman’s fracture: a minimum 2-year follow-up study. J Orthop Surg Res 15, 372 (2020). https:// doi.org/10.1186/s13018-020-01911-3
  • [15] Muller EJ, Wick M, Muhr G. Traumatic spondylolisthesis of the axis: treatment rationale based on the stability of the different fracture types. Eur Spine J. 2000;9:123–128. doi: 10.1007/ s005860050222.
  • [16] Verheggen R, Jansen J. Hangman’s fracture: arguments in favor of surgical therapy for type II and III according to Edwards and Levine. Surg Neurol. 1998;49(3):253–261. doi: 10.1016/ S0090-3019(97)00300-5.
  • [17] Rajasekaran S, Vidyadhara S, Shetty AP. Iso-C3D fluoroscopy-based navigation in direct pedicle screw fixation of Hangman fracture: a case report. J Spinal Disord Tech. 2007;20(8):616–619. doi: 10.1097/BSD.0b013e318074f978.
  • [18] Roy-Camille R, Saillant G, Mazel C. Internal fixation of the unstable cervical spine by a posterior osteosynthesis with plats and screws. In: The Cervical Spine Research Society, editor. The cervical spine. 2. Philadelphia: Lippincott Williams & Wilkins; 1989. pp. 390–403.
  • [19] Salunke P, Sahoo SK, Krishnan P, Chaterjee D, Sodhi HB. Are C2 pars-pedicle screws alonefor type II Hangman’s fracture overrated? Clin Neurol Neurosurg 2016;141:7–12.
There are 19 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Case Reports
Authors

Halil Can Küçükyıldız 0000-0003-0922-1750

Mustafa Karademir 0000-0002-0734-9040

Giray Güneş 0000-0003-4610-414X

Ünal Özüm 0000-0003-2065-2033

Publication Date December 31, 2021
Acceptance Date December 31, 2021
Published in Issue Year 2021

Cite

AMA Küçükyıldız HC, Karademir M, Güneş G, Özüm Ü. C2 transpedicular fixation technique in Hangman’s Fracture. CMJ. December 2021;43(4):431-436. doi:10.7197/cmj.981538