Traumatic spondylolisthesis of the axis: 42 cases.
Fourty-two patients (34 males and 8 female) with traumatic spondylolisthesis of the axis were studied in a retrospective review There were 20 stable and 22 unstable fractures. The 22 unstable fractures were treated surgically: 16 anterior interbody fusion (10 non-plated and 6 plated), 4 pedicle screw fixation for osteosynthesis of the fractured pedicles, and 2 posterior wire fixation for flexion and axial load injury. For all non-surgical cases, head halter tractions for 1 to 8 weeks was prescribed and a cervical orthosis was worn for an additional 6 to 18 weeks. The surgical cases underwent 5 to 7 days of preoperative and 1 to 4 weeks of post-operative head halter traction. In all cases pedicle fractures united after 13 weeks on average in group treated conservatively, 12 weeks (11 to 13 weeks) in the posterior wiring group, 8 weeks (7 to 9 weeks) in the group in which pedicle screws were used, and 11 weeks (9 to 15 weeks) in the anterior fusion group (13 weeks in non-plated, and 8 weeks in plated). There were no differences in patterns of anterior fusion between those in the non-plated and plated groups. There were no non-unions of fractured pedicles and there was no late instability of the C2-C3 or neurological complications. In 2 cases in the posterior surgery group, there was mild nuchal discomfort and some rigidity for a short while postoperatively. Final outcomes were good in all cases.
Moon
M S
MS
Spine Center, Sun General Hospital, Taejon, Korea.
Moon
J L
JL
Moon
Y W
YW
Sun
D H
DH
Choi
W T
WT
D000328:Adult; D001368:Axis, Cervical Vertebra / Q000000981:diagnostic imaging / Q000293:injuries*; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D013168:Spondylolisthesis / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome