Abstract

Purpose. To evaluate the treatment efficacy in patients with C2 hangman’s fracture. Materials and methods. During the period from 2012 to2015 in the Regional Neurosurgical Department 5 patients with hangman’s fracture of C2 vertebra underwent surgery (3 males and 2 females). Fracture type II was diagnosed in 2 patients, IIа type — in 2 persons, type III — in 1 patient. All patients had such clinical symptoms as cervicalgia, deteriorating on the movement. Four patients underwent transpedicular stabilization of C1—C2–C3 with skeletezation of lateral mass, one patient had a combination of posterior instrumentation with anterior plating C2–C3 by Medtronic Atlantis. Posterior stabilization was achieved by Medronic Vertex system. Results. During the operation, all patients achieved fusion of an injured segement. The patients were activated the same or next day after surgery. The volume of rotational motion in craniovertebral junction was limited to 180є—200є, but this did not worse the quality of life of the (VAS 8.9 and 2.3, NDI 80.6—19.6 % before and within the investigation, respectively). CT control was performed in 6 months. Fracture healing and the complete stability of the damaged segment were achieved in 6 months. Conclusions. Surgical treatment of C2 hangman’s fractures by posterior transpedicular/transarticular or anterior-posterior stabilization is a high-effective method for rapid restoration of ordinary physically active social life.

Highlights

  • Four patients underwent transpedicular stabilization of C1—C2–C3 with skeletezation of lateral mass, one patient had a combination of posterior instrumentation with anterior plating C2–C3 by Medtronic Atlantis

  • Posterior stabilization was achieved by Medronic Vertex system

  • Surgical treatment of C2 hangman’s fractures by posterior transpedicular/transarticular or anterior-posterior stabilization is a higheffective method for rapid restoration of ordinary physically active social life

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Summary

Materials and methods

During the period from 2012 to 2015 in the Regional Neurosurgical Department 5 patients with hangman’s fracture of C2 vertebra underwent surgery (3 males and 2 females). Fracture type II was diagnosed in 2 patients, IIа type — in 2 persons, type III — in 1 patient. All patients had such clinical symptoms as cervicalgia, deteriorating on the movement. Four patients underwent transpedicular stabilization of C1—C2–C3 with skeletezation of lateral mass, one patient had a combination of posterior instrumentation with anterior plating C2–C3 by Medtronic Atlantis. Posterior stabilization was achieved by Medronic Vertex system

Results
Conclusions
Spinal Cord Medicine

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