title: [Anterior cervical discectomy and fusion in the treatment of Hangman's fracture].
abstract: OBJECTIVE
  To evaluate the efficacies and features of treating Hangman's fracture by anterior cervical discectomy and fusion (ACDF).
  
  
  METHODS
  Since June 2005 to December 2008, 36 cases with Hangman's fracture were analyzed with their clinical data including history, symptoms, signs, radiological findings and treatments. According to the classification system designed by Levine and Edwards depending on the radiological manifestations of Hangman's fractures, they were subdivided into type I (n = 9) (conservative therapy), type II (n = 17) and type IIA (n = 10). Conservative therapy was offered to type I in 9 cases, while ACDF with cervical gear protection for 4 weeks after surgery was performed to type II in 17 cases and type IIA in 10 cases. A combination of operation time, days of hospitalization, complications, neurological improvement and fusion rate was assessed.
  
  
  RESULTS
  An average follow-up of 15 months (range: 10 - 36) was achieved. No vertebral redisplacement and angulation deformity occurred. Axial pain was relieved in each case. The preoperative neurological deficits in all patients got improvements. No spinal cord injury, vertebral artery injury or cerebrospinal fluid leakage occurred. No complication related to internal fixator was found. Average operative time and hospitalization were similar to those of ACDF for lower cervical spine (98 minutes vs. 9 days). Fusion was achieved within 6 months in all cases.
  
  
  CONCLUSIONS
  ACDF at C2-C3 may be an effective and safe way to treat Hangman's fracture.
authors.affiliation: Department of Spinal Surgery, Tianjin Hospital, Tianjin 300211, China. mayi@medmail.com.cn
authors.forename: Yi
authors.initials: Y
authors.lastname: Ma
authors.forename: Shu-cai
authors.initials: SC
authors.lastname: Deng
authors.forename: Jian-kun
authors.initials: JK
authors.lastname: Liu
authors.forename: Yong-hong
authors.initials: YH
authors.lastname: Hao
authors.forename: Jian-jiang
authors.initials: JJ
authors.lastname: Li
authors.forename: Gong-yi
authors.initials: GY
authors.lastname: Lü
mesh_terms: D000328:Adult; D016025:Bone Transplantation; D017586:Diskectomy / Q000379:methods*; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000601:surgery*; D013123:Spinal Fusion; D055815:Young Adult