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

Ge, Chao-Yuan; Hao, Dingjun; He, Baorong; Mi, Baibing

doi:10.1097/bsd.0000000000000150

Cited by 22 publications

(16 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Different surgical approaches, both anterior and posterior, have been described for treating Hangman's fracture [14,15]. An anterior approach has the advantage of a technically simple and relatively short fusion construct involving a C2-C3 discectomy with interbody fusion and plating [16,17]. The anterior approach, however, cannot address the detached posterior arch of C2 and may have approach-related problems.…”

Section: Discussionmentioning

confidence: 99%

A new transpedicular lag screw fixation for treatment of unstable Hangman’s fracture: a minimum 2-year follow-up study

Liu

Zhu

et al. 2020

J Orthop Surg Res

View full text Add to dashboard Cite

Background: A new C2 transpedicular lag screw designed by our team has been used in human cadaver spines for biomechanical testing, and the results showed that the biomechanical properties of the new C2 transpedicular lag screw were better than ordinary screws. The objective of this study is to analyze the clinical efficacy and safety of the new C2 transpedicular lag screw fixation for the treatment of unstable Hangman's fracture. Methods: From March 2013 to June 2017, 25 patients who had unstable Hangman's fractures were operated on with a new C2 transpedicular lag screw fixation. The patients included 18 males and 7 females whose ages ranged from 31 to 62 years (average 45.4 ± 9.3 years). The cause of the injury was a traffic accident in 17 patients and a fall from height in 8 patients. Other associated lesions included rupture of the spleen (1 patient) and rib fractures (2 patients). According to the Levine-Edwards classification, 17 patients were type II and 8 patients were type IIA, and according to the Frankel Neurological Performance scale, 8 cases and 17 cases were graded as spinal cord injury D and E, respectively. Twenty-three cases received bilateral screw fixation, and 2 cases had unilateral screw fixation because another pedicle was chipped. The whole procedure was accomplished with monitoring by "C"-arm fluoroscopy. Results: The mean follow-up time was 36 ± 12 months and ranged from 24 to 60 months. No obvious symptomatic or radiologic postoperative complications were found during the follow-up period. Six cases were restored from D to E while 2 cases remained D according to the American Spinal Injury Association (ASIA) grade. Pre-and postoperative visual analogue scale (VAS) and Neck Disability Index (NDI) were statistically different (P < 0.001). Osseous union was achieved in all cases, and the range of cervical motion recovered to the normal level up to the last follow-up. Conclusions: The primary clinical and radiographic efficacies of a new C2 transpedicular lag screw fixation for the treatment of unstable Hangman's fracture were satisfactory. This approach could be considered a simple, effective, reliable, and economic surgical method for managing unstable Hangman's fractures.

show abstract

Section: Discussionmentioning

confidence: 99%

A new transpedicular lag screw fixation for treatment of unstable Hangman’s fracture: a minimum 2-year follow-up study

Liu

Zhu

et al. 2020

J Orthop Surg Res

View full text Add to dashboard Cite

show abstract

“…14,15 An anterior approach, which has the advantage of a technically simple and relatively short fusion construct involving a C2-C3 discectomy with interbody fusion and plating. 16,17 The anterior approach, however, cannot address the detached posterior arch of C2 and may have approach-related problems. The high risks of anterior approach were mainly embodied in injuries to vital structures, especially in the facial and hypoglossal nerves, branches of the external carotid artery, contents of the carotid sheath and the superior laryngeal nerve.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the successful placement of cervical pedicle screws requires a 3-dimensional knowledge of the pedicle morphology to identify an ideal screw axis accurately and to avoid neuro-vascular injury. 17,22 Accordingly, the rate of injury to vital structures varied between 11% and 66%, 23,24 which motivated adequate preoperative examination. CT scanning with 3-dimensional reconstruction or a MRI evaluation of the spine is essential for detecting individual variations in the dimensions of the pedicle before surgery.…”

Section: Discussionmentioning

confidence: 99%

A new transpedicular lag-screw fixation for treatment of unstable Hangman’s fracture: a minimum 2-year follow-up study

Liu

Zhu

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: A new C2 transpedicular lag-screw designed by our team has been used in human cadaver spines for biomechanical testing, and the results showed that the biomechanical properties of the new C2 transpedicular lag-screw were better than ordinary screws. The objective of this study is to analyze the clinical efficacy and safety of the new C2 transpedicular lag-screw fixation for treatment of an unstable Hangman’s fracture. Methods: From March 2013 to June 2017, 25 patients who had unstable Hangman’s fractures were operated on with a new C2 transpedicular lag-screw fixation. The patients included 18 males and 7 females whose ages ranged from 31-62 years (average 45.4±9.3 years). The cause of the injury was a traffic accident in 17 patients and a fall from height in 8 patients. Other associated lesions included rupture of the spleen (1 patient) and rib fractures (2 patients). According to the Levine-Edwards classification, 17 patients were Type II and 8 patients were Type IIA, and according to the Frankel Neurological Performance scale, 8 cases and 17 cases were graded as spinal cord injury D and E, respectively. 23 cases received bilateral screw fixation and 2 cases had unilateral screw fixation because another pedicle was chipped. The whole procedure was accomplished with monitoring by“C”-arm fluoroscopy. Results: The mean follow-up time was (36±12) months and ranged from 24 to 60 months. No obvious symptomatic or radiologic postoperative complications were found during the follow-up period. 6 cases restored from D to E while 2 cases remained D according to American Spinal Injury Association (ASIA) grade. Pre and postoperative Visual Analogue Scale (VAS) and Neck Disability Index (NDI) were statistically different (p<0.001). Osseous union was achieved in all cases, and the range of cervical motion recovered to normal level up to the last follow-up. Conclusions: The primary clinical and radiographic efficacies of a new C2 transpedicular lag-screw fixation for treatment of an unstable Hangman’s fracture were satisfactory. This approach could be considered a simple, effective, reliable and economic surgical method for managing unstable Hangman’s fractures.

show abstract

“…Следует отметить, что в литературе, посвященной анализу методик фиксации, не расставляются подобные акценты (по протяженности, локализации и нозологии) [8,9,17], что подтверждает оригинальность полученных данных. Реализация этих преимуществ осуществляется только посредством непременного использования винтовой фиксации [17], которая является относительно более безопасной, даже при наличии мальпозиций элементов металлоконструкции [14,15].…”

Section: Discussionunclassified

Comparative characteristic of anterior and posterior stabilization of the cervical spine during surgical interventions

et al. 2020

View full text Add to dashboard Cite

Objective. To analyze possibilities and limitations of various stabilization technologies in the surgical treatment of cervical spine pathology. Material and Methods. Study design: retrospective monocentric observational analysis. Level of evidence: 3b (UK Oxford, version 2009). Diagnostic and treatment data are presented for 433 patients operated on using stabilization systems: patients in Group 1 (n = 228) underwent anterior fixation, those in Group 2 (n = 175)-posterior fixation with polyaxial screw systems, and in Group 3 (n = 30)-combined (anterior and posterior) fixation.

show abstract

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

Cited by 22 publications

References 28 publications

A new transpedicular lag screw fixation for treatment of unstable Hangman’s fracture: a minimum 2-year follow-up study

A new transpedicular lag screw fixation for treatment of unstable Hangman’s fracture: a minimum 2-year follow-up study

A new transpedicular lag-screw fixation for treatment of unstable Hangman’s fracture: a minimum 2-year follow-up study

Comparative characteristic of anterior and posterior stabilization of the cervical spine during surgical interventions

Contact Info

Product

Resources

About