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Traumatic spondylolisthesis of the axis: epidemiology, management and outcome
Fernando Portilho Ferro1, Gustavo Dias Borgo1, Olavo Biraghi Letaif1
1Spine Group of the Institute of Orthopedics and Traumatology of Hospital das Clínicas of the School of Medicine of Universidade de São Paulo.
Objective:
To evaluate cases of traumatic spondylolisthesis of the axis and describe them in relation to epidemiology, classification, neurological deficit, healing time and treatment method.
Method:
A retrospective analysis of the medical records of patients treated between 2002 and 2010 at IOT-FMUSP.
Inclusion Criteria:
pars interarticularis fracture of C2.
Results:
68% were male patients, with a mean age of 39.1 years. We used the classification by Effendi, modified by Levine-Edwards. Type I fractures were observed in five patients (31.2%) and type II in eight patients (50%). Only three patients (18%) had type IIa fracture. There were no cases of type III. Mechanism: Eight car accidents and four falls. Other mechanisms: being run over, and diving accidents. Treatment with halo traction was used in eleven patients, using minerva cast and halo-cast. Healing time: 3.6 months. Follow-up time: 9.6 months.
Discussion:
In general, hangman fracture has a good prognosis, which is confirmed by our results. There was no need for surgery in any of the cases. The incidence of neurological deficit is low. No patient had unstable fracture (type III).
Conclusion:
This paper suggests that traumatic spondylolisthesis of the axis continues to be an injury that is successfully treated by conservative treatment in most cases. Level of Evidence -IV, Case series.
