Failure of C2-3 anterior arthrodesis for the treatment of atypical Hangman's fractures: A three case series.
Anterolisthesis
Arthrodesis
Atypical
Hangman’s fracture
Instrumentation
Spine
Trauma
Journal
Surgical neurology international
ISSN: 2229-5097
Titre abrégé: Surg Neurol Int
Pays: United States
ID NLM: 101535836
Informations de publication
Date de publication:
2020
2020
Historique:
received:
08
02
2020
accepted:
28
02
2020
entrez:
8
4
2020
pubmed:
8
4
2020
medline:
8
4
2020
Statut:
epublish
Résumé
Hangman's fractures (HF) are defined by bilateral fractures of pars interarticularis of the axis. Most can be treated with a collar. However, the treatment strategies for atypical HF (AHF) involve the pedicles, are unstable, and require fusion. Here, we present three cases of AHF that failed anterior arthrodesis warranting repeat anterior (one case), and posterior fusions (three cases). One female and two males, ranging from 48 to 69 years of age, presented with AHF. All three were originally treated with C2-3 anterior cervical discectomy/fusion, and all three failed (e.g., resulted in pseudarthrosis/ anterolisthesis/instability). The first patient required a secondary C3 corpectomy/C2-4 arthrodesis, with C1-C4 posterior instrumentation. The latter two patients required secondary C1-C3 posterior fusions. For all three patients, 3-12 months follow-up X-rays confirmed the excellent alignment of the instrumentation and bony fusion. Anterior arthrodesis can be utilized to treat AHF, but often fail when addressing AHF. All AHF warranted secondary posterior fusions (e.g., C1-C3 two cases; and C1-C4 one case) and a subset may additionally require more extensive anterior fusions (e.g., C2-C4 with corpectomy of C3).
Sections du résumé
BACKGROUND
BACKGROUND
Hangman's fractures (HF) are defined by bilateral fractures of pars interarticularis of the axis. Most can be treated with a collar. However, the treatment strategies for atypical HF (AHF) involve the pedicles, are unstable, and require fusion. Here, we present three cases of AHF that failed anterior arthrodesis warranting repeat anterior (one case), and posterior fusions (three cases).
CASE DESCRIPTION
METHODS
One female and two males, ranging from 48 to 69 years of age, presented with AHF. All three were originally treated with C2-3 anterior cervical discectomy/fusion, and all three failed (e.g., resulted in pseudarthrosis/ anterolisthesis/instability). The first patient required a secondary C3 corpectomy/C2-4 arthrodesis, with C1-C4 posterior instrumentation. The latter two patients required secondary C1-C3 posterior fusions. For all three patients, 3-12 months follow-up X-rays confirmed the excellent alignment of the instrumentation and bony fusion.
CONCLUSION
CONCLUSIONS
Anterior arthrodesis can be utilized to treat AHF, but often fail when addressing AHF. All AHF warranted secondary posterior fusions (e.g., C1-C3 two cases; and C1-C4 one case) and a subset may additionally require more extensive anterior fusions (e.g., C2-C4 with corpectomy of C3).
Identifiants
pubmed: 32257578
doi: 10.25259/SNI_49_2020
pii: SNI-11-52
pmc: PMC7110422
doi:
Types de publication
Case Reports
Langues
eng
Pagination
52Informations de copyright
Copyright: © 2020 Surgical Neurology International.
Déclaration de conflit d'intérêts
There are no conflicts of interest.
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