Unstable Hangman Fracture Complicated by Vertebral-Venous Fistula: Surgical Considerations and Review of Literature.


Journal

World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275

Informations de publication

Date de publication:
01 2021
Historique:
received: 30 07 2020
revised: 18 09 2020
accepted: 19 09 2020
pubmed: 29 9 2020
medline: 4 6 2021
entrez: 28 9 2020
Statut: ppublish

Résumé

Hangman fracture or traumatic spondylolisthesis of the axis associated with a traumatic vertebral venous fistula (VVF) is a rare entity and sparsely reported in literature. Standard recommendations for management of such rare and complex scenarios are not available and hence the strategy has to be individualized on a case-by-case basis. We report a 70-year-old man having an unstable hangman fracture with VVF. Both pathologies were simultaneously managed uniquely. The VVF was managed by endovascular occlusion. The fracture was managed by anterior fusion alone as posterior fusion was deemed riskier in the aftermath of a recently occluded VVF. The patient had good neck function and bony fusion at 1-year follow-up. This case report emphasizes the need for timely recognition and management of a VVF, which can rarely coexist with hangman fracture, and discusses the interesting surgical paradigms in the management. We also present a review of literature.

Sections du résumé

BACKGROUND
Hangman fracture or traumatic spondylolisthesis of the axis associated with a traumatic vertebral venous fistula (VVF) is a rare entity and sparsely reported in literature. Standard recommendations for management of such rare and complex scenarios are not available and hence the strategy has to be individualized on a case-by-case basis.
METHODS
We report a 70-year-old man having an unstable hangman fracture with VVF. Both pathologies were simultaneously managed uniquely. The VVF was managed by endovascular occlusion. The fracture was managed by anterior fusion alone as posterior fusion was deemed riskier in the aftermath of a recently occluded VVF. The patient had good neck function and bony fusion at 1-year follow-up.
CONCLUSION
This case report emphasizes the need for timely recognition and management of a VVF, which can rarely coexist with hangman fracture, and discusses the interesting surgical paradigms in the management. We also present a review of literature.

Identifiants

pubmed: 32987171
pii: S1878-8750(20)32117-3
doi: 10.1016/j.wneu.2020.09.109
pii:
doi:

Types de publication

Case Reports Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

409-415

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Auteurs

Venugopal Sarath Chander (V)

Institute of Neurosciences, Sakra World Hospital, Bellandur, Bangalore, India; Department of Spine Surgery, Sakra World Hospital, Bellandur, Bangalore, India.

Ramachandran Govindasamy (R)

Institute of Neurosciences, Sakra World Hospital, Bellandur, Bangalore, India; Department of Spine Surgery, Sakra World Hospital, Bellandur, Bangalore, India.

Satish Rudrappa (S)

Institute of Neurosciences, Sakra World Hospital, Bellandur, Bangalore, India; Department of Spine Surgery, Sakra World Hospital, Bellandur, Bangalore, India.

Swaroop Gopal (S)

Institute of Neurosciences, Sakra World Hospital, Bellandur, Bangalore, India; Department of Spine Surgery, Sakra World Hospital, Bellandur, Bangalore, India. Electronic address: swaroopdr@gmail.com.

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