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Cervical Lateral Mass and Pedicle Fracture Reduced with a Herbert Screw: A Technical Note
Antonio Colamaria1, Francesco Carbone1,2, Augusto Leone2,3
1Division of Neurosurgery, Policlinico "Riuniti" Foggia, University of Foggia, 71122 Foggia, Italy.
Background:
Traumatic fractures of the cervical spine pose significant challenges in management, particularly in young patients, where preserving mobility is crucial.
Patient Characteristics:
A 30-year-old woman presented with a C3 lateral mass and pedicle fracture following a motor vehicle collision. Initial conservative management with a rigid cervical collar for three months failed to reduce the diastasis, and the debilitating neck pain worsened. Preoperative imaging confirmed fracture instability without spinal cord compression.
Intervention And Outcome:
Preoperative screw trajectory planning was conducted with the My Spine MC system (Medacta), and fine-tuning was achieved on a 3D-printed model of the vertebra. A posterior midline approach was employed to expose the C3 vertebra, and a Herbert screw was inserted under fluoroscopic guidance. Imaging at three months demonstrated significant fracture reduction and early bone fusion. The patient achieved substantial improvement in functional mobility without complications.
Conclusion:
Herbert screw fixation holds potential as a less-invasive alternative to conventional posterior stabilization for selected cervical fractures. This technical note provides the reader with the required information to support surgical planning and execution.
