Traumatic spondylolisthesis of the axis treated with direct C2 pars screw.
OBJECTIVE
The optimal treatment modality for traumatic spondylolisthesis of the axis is still a controversial issue. Many conservative, posterior and anterior fixation techniques have been used to treat these injuries. The C2 pars (isthmus) was used as a novel screw anchor point in upper cervical spine injuries. The direct C2 pars screws are also used to fixate the posterior and anterior parts of the C2 vertebra.


METHODS
Four cases with traumatic spondylolisthesis of the axis were presented. The cases were classified as type II according to Levine and Edwards' classification. C2 pars was used to fixate the posterior C2 elements to the C2 body.


RESULTS
While a direct C2 pars screw was used for C2 fixation in two cases, a C2 pars-C3 lateral mass screw-plate system was used in the remaining two cases. A clinical and radiological improvement was achieved in all cases.


CONCLUSIONS
It is concluded that the C2 pars can be used as screw-bone interface in upper cervical spine traumas. The direct C2 pars screw can fixate the C2 in well-selected cases. The additional C2-3 fixation increases the C2-3 stability.
Lütfü Kirdar Research and Training Hospital, Neurosurgery Clinic, Istanbul, Turkey. sedalbayrak@yahoo.com
Sedat
S
Dalbayrak
Mesut
M
Yilmaz
Mustafa
M
Firidin
Sait
S
Naderi
D000328:Adult; D001368:Axis, Cervical Vertebra / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D001863:Bone Screws; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D013168:Spondylolisthesis / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult