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Pars screw fixation of a hangman's fracture: technical case report
Ruth Bristol1, Jeffrey S Henn, Curtis A Dickman
1Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
Objective And Importance:
Traumatic spondylolisthesis of the axis may be treated by external immobilization or surgical fixation.
Clinical Presentation:
We report the case of a 23-year-old man who sustained an Effendi Type II fracture of the axis, for which halo immobilization did not provide adequate stability.
Intervention:
The unstable fracture was treated by placing lag screws in the pars interarticularis of C2, which reduced the fracture directly but sacrificed no normal spinal motion. The patient developed a solid fusion, and cervical alignment was normal at his 6-month follow-up examination.
Conclusion:
Although this technique has been reported previously, it is more commonly used in multilevel cervical fusions than for stand-alone repair of C2. Management options, anatomy, and technical considerations for the treatment of traumatic spondylolisthesis are reviewed.
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