Treatment of pedicular fractures of the axis

Borne, G; Bedou, G; Pinaudeau, M

doi:10.3171/jns.1984.60.1.0088

Cited by 111 publications

(33 citation statements)

References 2 publications

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“…Majority of authors recently suggested that the presence of discoligamentous injury on top of bony injury would require surgery. Another reason for surgery is the shortening the course of treatment3,4,18,21,23,26,27).…”

Section: Discussionmentioning

confidence: 99%

“…Surgical stabilization has been described in both anterior and posterior approaches. Among the different posterior approaches, direct repair of the pars fracture with a screw across the fracture line has the advantage of preserving motion of the axis3,5,17). However, direct pars repair does not address instability at the disc.…”

Section: Discussionmentioning

confidence: 99%

“…It involves bilateral C2 pars interarticularis fracture with a variable degree of displacement of C2 on C3 vertebrae8,21). Although most Hangman's fractures are treated conservatively2,22), surgery is usually preferable in cases of highly unstable Hangman's fracture and fusion failure after rigid arthrodesis3,5,15,21,23). Surgical stabilization has been described using both anterior and posterior approaches17,20,21,26,27).…”

Section: Introductionmentioning

confidence: 99%

“…However, this technique cannot preserve the motion at intact C1-C2 segment. Posterior C2 pedicle - C3 lateral mass screw and rod fixation can be considered to preserve the motion of the axis in cases that direct repair of the pars fracture with a screw across the fracture line is possible3,5,23). The key difference between these two techniques is preservation of C1-C2 motion which may have difference in biomechanical features as well as clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Outcomes of Posterior C2-C3 Fixation for Unstable Hangman's Fracture Compared with Posterior C1-C3 Fusion

2014

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ObjectiveTo verify the clinical outcomes of posterior C2-C3 fixation for unstable Hangman's fracture compared with posterior C1-C3 fixation.MethodsTwenty 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.ConclusionC2-C3 group showed better clinical and biomechanical results than C1-C3 group in terms of axial pain and disability of neck.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Clinical Outcomes of Posterior C2-C3 Fixation for Unstable Hangman's Fracture Compared with Posterior C1-C3 Fusion

2014

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“…It involves bilateral C2 pars interarticularis fracture with a variable degree of displacement of C2 on C3 vertebrae9,19). Although most Hangman's fractures are treated conservatively2,20), surgery is usually preferable in cases of highly unstable Hangman's fracture and fusion failure after rigid arthrodesis3,5,14,19,21). Surgical stabilization has been described using both anterior and posterior approaches16,18,19,24,25).…”

Section: Introductionmentioning

confidence: 99%

Posterior C2-C3 Fixation for Unstable Hangman's Fracture

et al. 2013

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ObjectiveThis is a retrospective review of 13 unstable Hangman's fractures who underwent posterior C2-3 fixation to describe clinical outcomes with a literature review.MethodsThirteen patients for unstable Hangman's fracture were enrolled between July 2007 and June 2010 were included in this study. The medical records of all patients were reviewed. Concurrently, 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 1day, 1week, 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 17 months.ResultsMean age were 43 years old. Bone fusion was recognized in all cases at the final follow-up. The average preoperative VAS score for neck pain was 8.3±1.1, while the final follow-up VAS score was 2.07±0.8 (p<0.001). The average immediate postoperative NDI was 84% points and final NDI was 22% points (p<0.001). There were one case of infection and 1 case of screw loosening.ConclusionIn the treatment of the patients with unstable Hangman's fracture, posterior C2-C3 fusions is effective and curative treatments to achieve cervical spinal stability.

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Development of a VR Simulator for Training of Posterior Cervical Spine Fusion Surgery

Fujiwara

Oikawa

Ishikawa

et al. 2020

IEEJ Transactions Elec Engng

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It is important to avoid iatrogenic injuries of nerves and blood vessels during the pedicle screw insertion stage of posterior cervical spine decompression and fusion surgery. First, it is necessary to determine the length and angulation of the pedicle screws for safety and stability. Second, it is necessary to drill precise preparation holes for the pedicle screws using a pedicle probe. In this work, we developed a VR training system for pedicle screw planning and basic drilling skills. The VR system was built with a pen‐style haptic device and a head‐mounted display. Trainees used the haptic pen as a virtual pedicle probe. In order to simulate bone hardness and stress accumulation at the virtual pedicle probe tip in the virtual surgery, we developed a voxel‐based bone drilling simulator. To reduce the heavy load required for voxel processing, the simulator was constructed as a hybrid system that included a removal volume voxel model for drilling areas and a fixed polygonal mesh model for other areas. 3D models of a cervical spine were generated from CT scan images of a patient. This paper evaluated the system through a subjective evaluation by a specialist and via the training results for novice trainees. We discuss the evaluation results and training effectiveness with the simulator. © 2020 Institute of Electrical Engineers of Japan. Published by Wiley Periodicals LLC.

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Treatment of pedicular fractures of the axis

Cited by 111 publications

References 2 publications

Clinical Outcomes of Posterior C2-C3 Fixation for Unstable Hangman's Fracture Compared with Posterior C1-C3 Fusion

Clinical Outcomes of Posterior C2-C3 Fixation for Unstable Hangman's Fracture Compared with Posterior C1-C3 Fusion

Posterior C2-C3 Fixation for Unstable Hangman's Fracture

Development of a VR Simulator for Training of Posterior Cervical Spine Fusion Surgery

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