title: Clinical Outcomes of Posterior C2-C3 Fixation for Unstable Hangman's Fracture Compared with Posterior C1-C3 Fusion.
abstract: OBJECTIVE
  To verify the clinical outcomes of posterior C2-C3 fixation for unstable Hangman's fracture compared with posterior C1-C3 fixation.
  
  
  METHODS
  Twenty four patients for unstable Hangman's fracture were enrolled between July 2007 and June 2010 in this study. Thirteen patients underwent posterior C2-C3 fusion and 11 patients underwent posterior C1-C3 fusion. Clinical outcomes were evaluated using Neck Disability Index (NDI) scores and Visual Analogue Scale (VAS) scores during preoperative and postoperative follow up period. Plain radiographs were obtained on postoperative 1 day, 1 week, and then at 1, 2, 6, and 12 months. CT was done at postoperative 12 months in all patients for evaluation of bone fusion. The mean period of clinical follow-up was 15 months.
  
  
  RESULTS
  The mean ages were 43.3 years in C2-C3 group and 50.0 years in C1-C3 group. Mean follow-up period was 17.2 months in C2-C3 group and 16.3 months in C1-C3 group. VAS scores and NDI scores in C2-C3 group were much less than those in C1-C3 group at each follow-up period. The differences of VAS score and NDI scores between C2-C3 and C1-C3 groups at each follow-up period were statistically significant (p<0.001) by paired T-test. Solid Bone fusion was confirmed in all cases at the final follow-up.
  
  
  CONCLUSIONS
  C2-C3 group showed better clinical and biomechanical results than C1-C3 group in terms of axial pain and disability of neck.
authors.affiliation: Department of Neurosurgery, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Jun Hee
authors.initials: JH
authors.lastname: Park
authors.affiliation: Department of Neurosurgery, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Sang Hyun
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Ki Hong
authors.initials: KH
authors.lastname: Cho
keywords: Fracture; Posterior fixation; Spondylolisthesis; Trauma; Unstable
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