Anterior discectomy and fusion with internal fixation for unstable hangman's fracture.
Between 1999 and 2004, 28 patients (average age: 41, range: 18-70 years) with unstable hangman's fracture underwent anterior discectomy and fusion with internal fixation at our unit. According to the Levine-Edwards classification, all cases were unstable with type II (10 cases), type IIA (17 cases) and type III (1 case). An average follow-up of 15 months was achieved (range: 3-48 months). The average operative time was 107 min (80-131 min). No patient received blood transfusion. No patient experienced worsening neurological function postoperatively. No other intra- or postoperative complication was observed. All patients were relieved from axial pain. Neurological status improved postoperatively in all four cases with neurological deficit. Each patient showed evidence of a solid anterior C2-3 interbody fusion after six months. No bone graft or plate screws complication was observed in any of the cases during the follow-up period. In our experience the anterior approach with primary internal stabilisation may be a feasible and safe method to treat unstable hangman's fracture.
Department of Orthopaedics, Changhai Hospital, Second Military Medical University, No. 168, Changhai Road, Shanghai 200433, People's Republic of China. xuhaomouse2004@yahoo.com.cn
Hao
H
Xu
Jie
J
Zhao
Jiandong
J
Yuan
Cong
C
Wang
D000293:Adolescent; D000328:Adult; D000368:Aged; D001368:Axis, Cervical Vertebra / Q000293:injuries / Q000601:surgery*; D001860:Bone Plates; D001863:Bone Screws; D016025:Bone Transplantation; D002574:Cervical Vertebrae / Q000293:injuries / Q000601:surgery*; D017586:Diskectomy / Q000379:methods*; D005593:Fracture Fixation, Internal; D017102:Fracture Healing; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000503:physiopathology; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D013168:Spondylolisthesis / Q000150:complications / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult