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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2015

Open Access 01-12-2015 | Research article

Cervical cage without plating in management of type II / II A Hangman’s fracture combined with intervertebral disc injury

Authors: Fuxin Wei, Le Wang, Zhiyu Zhou, Rui Zhong, Shaoyu Liu, Shangbin Cui, Ximin Pan, Manman Gao

Published in: BMC Musculoskeletal Disorders | Issue 1/2015

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Abstract

Background

Surgical intervention is increasingly performed as the primary treatment of unstable Hangman’s fracture. Some authors have advocated using anterior C2/3 discectomy with interbody fusion and plating to treat unstable Hangman’s fracture combined with intervertebral disc injury; however, there are few reports on unstable Hangman’s fracture treated by anterior interbody fusion with the cervical cage (PEEK material) solely.

Methods

This study was to assess the efficacy of the cervical cage in management of unstable Hangman’s fracture combined with intervertebral disc injury. A cohort of 15 patients with unstable Hangman’s fractures fulfilling the inclusion criteria were prospectively submitted to surgical treatment of anterior C2/3 discectomy and interbody fusion using the cervical cage without plating. According to the Levine and Edwards classification, there were 5 type II, and 10 type IIA cases. The clinical outcome (the visual analog scale and the clinical post-traumatic neck score), radiological findings (angulation, translation, and disc height), and bone healing were assessed at 3, 6, 12, and 24 months.

Results

All the patients were followed up successfully. There were no intra- or postoperative complications observed. Solid fusion was achieved in all cases by 6 months after surgery. The local kyphotic angle was corrected significantly with the mean preoperative 12.31 ± 2.96 degrees, initial postoperative −1.98 ± 1.62 degrees and the latest follow-up −1.72 ± 1.60 degrees respectively (P < 0.05).The translation was also corrected significantly with the mean preoperative 3.20 ± 1.16 mm, initial postoperative 0.97 ± 0.36 mm, and the latest follow-up 1.05 ± 0.34 mm respectively (P < 0.05). The mean visual analog scale and the clinical post-traumatic neck score improved significantly following surgery (P < 0.05).

Conclusions

This case series demonstrates that anterior C2/3 discectomy and interbody fusion with the cervical cage solely is effective and reliable in management of type II / IIA Hangman’s fracture with C2/3 disc injury when properly indicated.
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Metadata
Title
Cervical cage without plating in management of type II / II A Hangman’s fracture combined with intervertebral disc injury
Authors
Fuxin Wei
Le Wang
Zhiyu Zhou
Rui Zhong
Shaoyu Liu
Shangbin Cui
Ximin Pan
Manman Gao
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2015
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-015-0734-8

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