Direct C2 Pedicle Screw Fixation for Axis Body Fracture

Reynolds, James M.; MacDonald, Joel D.

doi:10.1016/j.wneu.2016.06.047

Cited by 6 publications

(5 citation statements)

References 23 publications

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“…This technique is usually indicated for pure osseous injuries without disc injuries, ligamentous injuries, or dislocations. This procedure has been reported in numerous articles as a treatment for selected C2 hangman's fractures [ 4 , 5 ] and has also been used in the treatment of C2 complex fractures with favorable outcomes [ 6 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…The horizontal rostral type is the same as the so-called type III odontoid process fracture described by Anderson and D'Alonzo. In patients without obvious instability, most fractures have been treated conservatively, though the clinical results have not always been satisfactory [ 7 , 9 ]. Therefore, some patients require spinal fixation.…”

Section: Discussionmentioning

confidence: 99%

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Direct Screw Osteosynthesis for an Elderly Osteoporotic Patient With C2 Complex Fracture

Nagashima¹,

Nishimura²,

Matsuo³

et al. 2023

Cureus

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There are various types of C2 fractures, including odontoid fractures, hangman fractures, and complex fractures, which involve the vertebral body or multiple fracture types. The published literature on C2 complex fractures is limited, and treatment strategies have not yet been established. An 80-year-old woman with a history of osteoporosis, brain stroke, and cervical spondylosis fell and sustained a C2 complex fracture. Initial treatment with a cervical collar was unsuccessful and a C2 direct screw osteosynthesis surgery was performed under an image-guided three-dimensional navigation system. The surgical procedure was successfully performed with a surgical time of 83 minutes and a blood loss of 31 ml. Her neck pain improved after surgery. Follow-up CT scans revealed acceptable healing of the fracture four months later. C2 direct screw osteosynthesis is a viable treatment option for C2 complex fractures, particularly in elderly patients who may benefit from early stabilization of the fracture to prevent complications associated with long-term conservative treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Direct Screw Osteosynthesis for an Elderly Osteoporotic Patient With C2 Complex Fracture

Nagashima¹,

Nishimura²,

Matsuo³

et al. 2023

Cureus

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“…[23,24] Atlantoaxial instability caused by C2 fractures need surgical reduction and stabilization to limit the anterior displacement of atlas effectively and enhance the atlantoaxial sagittal stability to prevent further spinal cord injury. [25,14] Because of the anatomical peculiarity of the axis and the complexity of injury pathology, clinical management of the axis fractures was hard work for spine surgeon. [15] Among the treatment of axis fractures, the posterior pedicles screws xation was preferred for its relative simple exposure with no major vascular and visceral structures.…”

Section: Discussionmentioning

confidence: 99%

Cervical pedicle screws fixation treatment the atlantoaxial instability of axis burst fractures

Yan¹,

Zhang²,

Zhang

2020

Preprint

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BackgroundAlthough the cervical pedicle screws and rods were used for atlantoaxial instable, the axis fractures still a challenge for spine surgeon. ObjectiveThis study was to evaluated the clinical outcomes of axis burst fractures had C1C3 pedicles screws fixation treatment. MethodsFrom June 2014 to July 2018, 45 patients with axis fractures were enrolled in this study; 23 patients was odontoid underwent C1C2 pedicles screws fixation, and 21 patients was odontoid combine body fractures had C1C3 pedicles screws fixation. The clinical outcomes of pain relief (visual analog scale, VAS), functional disability (neck disability index, NDI) were recorded at baseline and at the final follow-up. ResultsThe pain index and NDI were all significantly improved when compared to pretreatment (P < 0.01).The VAS and ND were no significant difference between two groups (P > 0.05). All patients, suffered from severe mechanical upper cervical neck pain at pre-operative, were pain free post-operation. Preoperative neurological examination was normal in all patients, and remained the same after surgery.All cases showed normal neurological function at the final follow-up. No vascular or neurological complication was noted. The fracture healing and the bony union of the fixed segments were revealed in all cases on CT views. Implant failure and instability were not seen on lateral flexion/extension radiographs of the cervical spine. ConclusionsCervical pedicle screws fixation was effective and safe procedures in the treatment of traumatic spondylolisthesis of axial fractures. The atlantoaxial instable of axis burst fractures can be managed with C1-C3 pedicles screws fixation. AcknowledgementsWe sincerely appreciated the genial help from all scholars who contributed to our research. AbbreviationsVAS: visual analog scale NDI: neck disability index 9 CT: computer tomography MRI: magnetic resonance imaging

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“…Although posterior fixation with a direct repair is a successful strategy, it is technically challenging and may not be anatomically possible in patients with small C2 pedicle dimensions or an atypical course of the vertebral artery [ 4 , 5 ]. An alternative, posterior strategy is C1-3 fusion, as the posterior elements of C2 are not attached to the anterior elements and cannot serve as a fixation point, thus necessitating the loss of both the C1-2 and C2-3 motion segments [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

A Potentially Advantageous Use of a Zero-Profile, Stand-Alone Anterior Interbody Spacer at C2-3 for the Treatment of Hangman’s Fracture: A Technical Case Report

Ashraf¹,

Houten²

2021

Cureus

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Hangman's fracture or traumatic spondylolisthesis of the axis is a common fracture pattern in the cervical spine. Nonoperative management with an external orthosis is appropriate in select cases. However, when surgery is necessary, both anterior and posterior approaches can be used, and the optimal approach has not been established. Anterior discectomy and fusion with plating at C2-3 may cause dysphagia from plate prominence, while the posterior fusion of C1-3 eliminates motion of an otherwise healthy atlantoaxial joint, resulting in a significant loss of cervical range of motion. We describe the first published application of a stand-alone, zero-profile implant at the C2-3 segment to treat Hangman's fracture, a technique already successfully used in the C3-7 region for trauma and degenerative applications. A stand-alone, zero profile interbody spacer was employed in anterior C2-3 arthrodesis surgery for Hangman's fracture in a 61-year-old female following failure of healing after three months in a hard cervical collar. Late postoperative imaging showed successful fusion and the patient had favorable clinical results with relief of neck pain. A zeroprofile, stand-alone implant at C2/3 is an attractive option to surgically treat C2 Hangman's fracture, potentially minimizing dysphagia attributable to an anterior plate and spare the atlantoaxial joint that is fused with C1-3 posterior arthrodesis. The benefits of the application of this technique may be validated with additional studies.

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Direct C2 Pedicle Screw Fixation for Axis Body Fracture

Cited by 6 publications

References 23 publications

Direct Screw Osteosynthesis for an Elderly Osteoporotic Patient With C2 Complex Fracture

Direct Screw Osteosynthesis for an Elderly Osteoporotic Patient With C2 Complex Fracture

Cervical pedicle screws fixation treatment the atlantoaxial instability of axis burst fractures

A Potentially Advantageous Use of a Zero-Profile, Stand-Alone Anterior Interbody Spacer at C2-3 for the Treatment of Hangman’s Fracture: A Technical Case Report

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