Anterior C3 corpectomy and fusion for complex Hangman’s fractures

Ma, Hui; Yuan, Wen; Wang, Xinwei; Chen, Huajiang; Wu, Xiaodong

doi:10.1007/s00264-012-1703-6

Cited by 8 publications

(6 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The anterior cervical plate technique, first proposed in the 1980s, has the advantage of excising the scathing disk-ligament complex, which has a potential risk of instability. 23 It is also directly decompressive for the spinal cord by removal of the disk tissue in the spinal canal. In our study, 5 cases with traumatic C2-3 disk herniation compressing the spinal cord were treated with ACDF successfully and they all showed an apparent improvement of neurological function postoperatively.…”

Section: Discussionmentioning

confidence: 99%

“…10 However, visible injuries to the anterior ligament and disk are neglected with a potential risk of instability. 23 Moreover, the highly variable anatomy of the upper cervical spine and the presence of surrounding neurovascular structures, such as the spinal cord, nerve roots, and vertebral artery, make posterior screw fixation technically challenging, especially the insertion of C2 pedicle screws. The accuracy of C2 pedicle screws placement cannot be guaranteed yet, even under intraoperative 3-dimensional fluoroscopy-based navigation.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Anterior Cervical Discectomy and Fusion Versus Posterior Fixation and Fusion of C2–3 for Unstable Hangman’s Fracture

Hao

et al. 2015

Journal of Spinal Disorders &Amp; Techniques

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Anterior Cervical Discectomy and Fusion Versus Posterior Fixation and Fusion of C2–3 for Unstable Hangman’s Fracture

Hao

et al. 2015

Journal of Spinal Disorders &Amp; Techniques

View full text Add to dashboard Cite

show abstract

“…The main disadvantage of conservative treatment is the prolonged time (3-6 months) in halo traction. 31,32 In addition, the anterior and posterior longitudinal ligaments and especially the intervertebral discs play important roles in the stability of hangman's fractures. An unstable hangman's fracture is often associated with intervertebral disc injury, which may lead to instability of the cervical spine, and disc herniation may lead to medullary compression.…”

Section: Discussionmentioning

confidence: 99%

“…3,8,13,15,[17][18][19]21,23,25,28,31,33,34 Posterior surgery was previously performed using C1-3 wire fixation, but this technique requires postoperative halo vest immobilization and sacrifices atlantoaxial function. 13 Bristol et al 3 treated the atlantoaxial isthmus fracture by direct screw fixation to retain atlantoaxial function.…”

mentioning

confidence: 99%

Anterior discectomy/corpectomy and fusion with internal fixation for the treatment of unstable hangman's fractures: a retrospective study of 38 cases

Hou

Zhao

et al. 2015

SPI

View full text Add to dashboard Cite

OBJECT The object of this study was to describe the authors' method of anterior discectomy/corpectomy and fusion combined with internal fixation for the treatment of unstable hangman's fractures and to evaluate the clinical and radiological outcomes. METHODS This study included 38 consecutive patients who underwent surgery for unstable hangman's fractures between July 2002 and October 2011 and were followed up for more than 2 years. The patients were 18 women and 20 men with a mean age of 42.8 years (range 20–69 years). The fracture resulted from a fall in 9 patients, a motor vehicle accident in 21 patients, and a motorcycle accident in 8 patients. The Levine-Edwards classification was Type II in 13 patients, Type IIA in 20 patients, and Type III in 5 patients. All patients underwent anterior C2–3 intervertebral disc excision or C-3 corpectomy, decompression and reduction, interbody implantation of an autologous iliac bone graft, and internal fixation with a titanium plate. Pain was assessed before and after surgery using a visual analog scale (VAS). Myelopathy was graded using the Japanese Orthopaedic Association (JOA) score. Patient satisfaction with the surgery was assessed using Odom's grading system. Anteroposterior, lateral, and dynamic (flexion/extension) radiographs were obtained during the follow-up period. Two-dimensional CT studies with sagittal and coronal reconstructions were routinely performed. RESULTS The mean follow-up period was 49.2 months (range 24–132 months). There was a significant decrease between the preoperative and final follow-up VAS scores (mean [SD] 7.56 ± 1.52 vs 2.36 ± 1.25, p < 0.05) and a significant increase between the preoperative and final follow-up JOA scores (12.58 ± 1.34 vs 16.13 ± 1.17, p < 0.05). Postoperative radiographs showed satisfactory reduction of the fracture in all cases. Postoperative complications included transient neurological deficits (3 cases), hematoma (2 cases), temporary dysphagia (5 cases), temporary hoarseness (2 cases), prolonged pain at the iliac crest donor site (4 cases), and wound infection at the iliac crest donor site (2 cases). Solid fusion was achieved in 94.7% of patients at the final follow-up. CONCLUSIONS Anterior discectomy/corpectomy and fusion combined with internal fixation is a safe and effective procedure for the treatment of unstable hangman's fractures.

show abstract

“…Management of the tear drop fractures are based on the stability of the cervical segment. The spectrum of management varies from conservative to surgical including immobilization, traction, corpectomy with fusion, corpectomy and fusion with prolonged skeletal traction or fixation via combined anterior and posterior approach, anterior decompression with plate fixation etc [4] . Anterior decompression with plate fixation is the standard treatment for unstable tear drop fractures.…”

Section: Introductionmentioning

confidence: 99%

Anterior Cervical Plating for An Axis Tear Drop Fracture: Case Report

Govindan¹,

Ds²,

Kumar³

et al. 2016

International Journal of Orthopaedics

View full text Add to dashboard Cite

anterior cord syndrome. We present a case of traumatic unstable C2 flexion tear drop fracture without neurological deficit. We have treated the patient successfully with anterior cervical plating and tricortical bone grafting after removal of tear drop fragment and discectomy. This patient was mobilized on next day after surgery and neck mobilization started after 3 weeks. The patient in our study was followed up for 6 years and found to have no sequlae related to the injury. Unstable tear drop fracture needs to be fixed irrespective of the presence or absence of neurological deficit. Open reduction internal fixation with low profile plate and tricortical bone graft, shaped to fit the defect and disc space, through high anterior retropharyngeal approach is a promising treatment for unstable tear drop fractures. Key words: INTRODUCTIONTear drop fractures are rare injuries occurring in upper and lower cervical region. It occurs most often at C5 vertebrae followed by C6 and C4, sometimes involving the nearby vertebrae [1] . The reason for this is that normal cervical spine has a lordotic angle and the stress is more on C5 during flexion of the neck [2] . In the upper cervical region, axis vertebrae fracture is the most commonly reported and the incidence come to nearly 3% of cervical spine injuries [3] . Like any other tear drop fractures C2 tear drop fractures are also caused by flexion and hyper extension injuries. Management of the tear drop fractures are based on the stability of the cervical segment. The spectrum of management varies from conservative to surgical including immobilization, traction, corpectomy with fusion,

show abstract

Anterior C3 corpectomy and fusion for complex Hangman’s fractures

Cited by 8 publications

References 21 publications

Anterior Cervical Discectomy and Fusion Versus Posterior Fixation and Fusion of C2–3 for Unstable Hangman’s Fracture

Anterior Cervical Discectomy and Fusion Versus Posterior Fixation and Fusion of C2–3 for Unstable Hangman’s Fracture

Anterior discectomy/corpectomy and fusion with internal fixation for the treatment of unstable hangman's fractures: a retrospective study of 38 cases

Anterior Cervical Plating for An Axis Tear Drop Fracture: Case Report

Contact Info

Product

Resources

About