title: A new technique in the surgical treatment of Hangman's fractures: Neurospinal Academy (NSA) technique.
abstract: BACKGROUND
  Treatment of Hangman's fractures is still controversial. Hangman's fractures Type II and IIA are usually treated with surgical procedures.
  
  
  OBJECTIVE
  This study aims at describing the Neurospinal Academy (NSA) technique as an attempt to achieve an approximation of the fracture line to the axis body, which may be used for Type II and IIA patients with severe displacement and angulation.
  
  
  METHODS
  NSA technique both pars or pedicle screws are placed bicortically to ensure that anterior surface of C2 vertebral body will be crossed 1-2 mm. A rod is prepared in suitable length and curve to connect the two screws. For placing the rod, sufficient amount of bone is resected from the C2 spinous process. C2 vertebral body is pulled back by means of the screws that crossed the anterior surface of C2 vertebral body.
  
  
  METHODS
  Hangman II and IIA patient are treated with NSA technique.
  
  
  RESULTS
  Angulated and tilted C2 vertebral body was pulled back and approximated to posterior elements.
  
  
  CONCLUSIONS
  In Hangman's fractures Type II and IIA with severe vertebral body and pedicle displacement, NSA technique is an effective and reliable treatment alternative for the approximation of posterior elements to the C2 vertebral body, which is tilted, angulated, and dislocated.
authors.affiliation: Department of Neurosurgery, Neurospinal Academy, Istanbul, Turkey.
authors.forename: Sedat
authors.initials: S
authors.lastname: Dalbayrak
authors.affiliation: Clinic of Neurosurgery, Tepecik Education and Training Hospital, Izmir, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Yaman
authors.affiliation: Department of Neurosurgery, Neurospinal Academy, Istanbul, Turkey.
authors.forename: Mesut
authors.initials: M
authors.lastname: Yılmaz
keywords: Hangman's fracture; Type II; Type IIA; surgery
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