Direct Screw Osteosynthesis for an Elderly Osteoporotic Patient With C2 Complex Fracture

There are various types of C2 fractures, including odontoid fractures, hangman fractures, and complex fractures, which involve the vertebral body or multiple fracture types. The published literature on C2 complex fractures is limited, and treatment strategies have not yet been established. An 80-year-old woman with a history of osteoporosis, brain stroke, and cervical spondylosis fell and sustained a C2 complex fracture. Initial treatment with a cervical collar was unsuccessful and a C2 direct screw osteosynthesis surgery was performed under an image-guided three-dimensional navigation system. The surgical procedure was successfully performed with a surgical time of 83 minutes and a blood loss of 31 ml. Her neck pain improved after surgery. Follow-up CT scans revealed acceptable healing of the fracture four months later. C2 direct screw osteosynthesis is a viable treatment option for C2 complex fractures, particularly in elderly patients who may benefit from early stabilization of the fracture to prevent complications associated with long-term conservative treatment.