Lag Pedicle Screw Fixation Technique for Hangman’s Fracture
Year 2021,
Volume: 2 Issue: 1, 12 - 14, 03.07.2021
Densel Araç
,
Fatih Keskin
,
Mehmet Erdi
,
Yaşar Karataş
Abstract
Objective: We aim to evaluate the posterior peduncle lag screw technique performed in our clinic for Hangman’s fracture type 2 and 2A fractures in comparison with the literature.
Method: Between 2017 and 2020, 7 patients with Hangman’s fracture were operated with the posterior C2 pedİcle lag screw method. The average age of the patients, 6 men and 1 female, was 32.6 and none of our patients had any other pathology other than cervical fracture.
Results: There were no post-operative complications in 7 patients who were operated. In the 3rd month of the follow-up of all patients, ossification was observed in the fracture line. Screw malposition and malunion were not observed.
Conclusion: The posterior pedicle lag screw fixation technique is a valuable technique in patients with Hangman’s fractures type 2 and 2A, as it is easy to apply, has less risk of complications, and preserves vertebral mobility.
References
- 1. Schneider RC, Livingston KE, Cave AJ, Hamilton G. “Hangman’s fracture” of the cervical spine. J Neurosurg 1965;22 (2):141–154 https://doi.org/10.3171/jns.1965.22.2.0141
- 2. M. Montalbano, C. Fisahn, M. Loukas, R. J. Oskouian, J. R. Chapman, and R. S. Tubbs, “Pediatric hangman’s fracture: a comprehensive review,” Pediatric Neurosurgery 2017;52(3): 145-150 DOI:10.1159/000455923
- 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:S90–5 doi: 10.1097/BOT.0000000000000952.
- 4. Sharpe JP, Magnotti LJ, Weinberg JA, Schroeppel TJ, Fabian TC, Croce MA. The old man and the C-spine fracture: impact of halo vest stabilization in patients with blunt cervical spine fractures. J Trauma Acute Care 2016;80:76–80 DOI: 10.1097/ta.0000000000000894
- 5. Ma W, Xu R, Liu J, Sun S, Zhao L, Hu Y et al. Posterior short-segment fixation and fusion in unstable Hangman’s fractures. Spine (Phila Pa 1976) 2011;36:529-533 doi: 10.1097/BRS.0b013e3181d60067.
- 6. Marton E, Billeci D, Carteri A. Therapeutic indications in upper cervical spine instability. Considerations on 58 cases. J Neurosurg Sci 2000;44(4):192–20 PMID: 11327288
- 7. Al-Mahfoudh R, Beagrie C, Woolley E, Zakaria R, Radon M, Clark S, et al. Management of typical and atypical hangman’s fractures. Global Spine J 2016; 6:248-256 doi: 10.1055/s-0035-1563404
- 8. Li XF, Dai LY, Lu H, Chen XD. A systematic review of the management of hangman’s fractures. Eur Spine J 2006;15: 257-269 DOI: 10.1007/s00586-005-0918-2
- 9. Naderi S, Arman C, Guvencer M, Korman E, Senoglu M, Tetik S, et al . An anatomical study of the C-2 pedicle. J Neurosurg Spine 2004;1:306-10
- 10. Dalbayrak S, Yılmaz M, Firidin M, Naderi S. Traumatic spondylolisthesis of the axis treated with direct c2 pars screw. Turk Neurosurg 2009;19:163-7 PMID: 19431128
- 11. Hakato J, Wrofski J. Operative treatment of hangman's fractures of C2. Posterior direct pars screw repair or anterior plate-cage stabilization? Neurol Neurochir Pol 2008;42:28-36 PMID: 18365960
- 12. Müller 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;9:123–8 doi: 10.1007/s005860050222.
- 13. ElMiligui Y, Koptan W, Emran I. Transpedicular screw fixation for type II Hangman’s fracture: a motion preserving procedure. Eur Spine J. 2010;19:1299–305 DOI: 10.1007/s00586-010-1401-2
- 14. Borne GM, Bedou GL, Pinaudeau M. Treatment of pedicular fractures of the axis. J Neurosurg. 1984;60:88–93 https://doi.org/10.3171/jns.1984.60.1.0088
Year 2021,
Volume: 2 Issue: 1, 12 - 14, 03.07.2021
Densel Araç
,
Fatih Keskin
,
Mehmet Erdi
,
Yaşar Karataş
References
- 1. Schneider RC, Livingston KE, Cave AJ, Hamilton G. “Hangman’s fracture” of the cervical spine. J Neurosurg 1965;22 (2):141–154 https://doi.org/10.3171/jns.1965.22.2.0141
- 2. M. Montalbano, C. Fisahn, M. Loukas, R. J. Oskouian, J. R. Chapman, and R. S. Tubbs, “Pediatric hangman’s fracture: a comprehensive review,” Pediatric Neurosurgery 2017;52(3): 145-150 DOI:10.1159/000455923
- 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:S90–5 doi: 10.1097/BOT.0000000000000952.
- 4. Sharpe JP, Magnotti LJ, Weinberg JA, Schroeppel TJ, Fabian TC, Croce MA. The old man and the C-spine fracture: impact of halo vest stabilization in patients with blunt cervical spine fractures. J Trauma Acute Care 2016;80:76–80 DOI: 10.1097/ta.0000000000000894
- 5. Ma W, Xu R, Liu J, Sun S, Zhao L, Hu Y et al. Posterior short-segment fixation and fusion in unstable Hangman’s fractures. Spine (Phila Pa 1976) 2011;36:529-533 doi: 10.1097/BRS.0b013e3181d60067.
- 6. Marton E, Billeci D, Carteri A. Therapeutic indications in upper cervical spine instability. Considerations on 58 cases. J Neurosurg Sci 2000;44(4):192–20 PMID: 11327288
- 7. Al-Mahfoudh R, Beagrie C, Woolley E, Zakaria R, Radon M, Clark S, et al. Management of typical and atypical hangman’s fractures. Global Spine J 2016; 6:248-256 doi: 10.1055/s-0035-1563404
- 8. Li XF, Dai LY, Lu H, Chen XD. A systematic review of the management of hangman’s fractures. Eur Spine J 2006;15: 257-269 DOI: 10.1007/s00586-005-0918-2
- 9. Naderi S, Arman C, Guvencer M, Korman E, Senoglu M, Tetik S, et al . An anatomical study of the C-2 pedicle. J Neurosurg Spine 2004;1:306-10
- 10. Dalbayrak S, Yılmaz M, Firidin M, Naderi S. Traumatic spondylolisthesis of the axis treated with direct c2 pars screw. Turk Neurosurg 2009;19:163-7 PMID: 19431128
- 11. Hakato J, Wrofski J. Operative treatment of hangman's fractures of C2. Posterior direct pars screw repair or anterior plate-cage stabilization? Neurol Neurochir Pol 2008;42:28-36 PMID: 18365960
- 12. Müller 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;9:123–8 doi: 10.1007/s005860050222.
- 13. ElMiligui Y, Koptan W, Emran I. Transpedicular screw fixation for type II Hangman’s fracture: a motion preserving procedure. Eur Spine J. 2010;19:1299–305 DOI: 10.1007/s00586-010-1401-2
- 14. Borne GM, Bedou GL, Pinaudeau M. Treatment of pedicular fractures of the axis. J Neurosurg. 1984;60:88–93 https://doi.org/10.3171/jns.1984.60.1.0088