Posterior C2/3 fixation for unstable Hangman's fractures by computer-assisted minimally invasive technique

JIN Peihao; TIAN Wei; LIU Yajun; LANG Zhao

doi:10.3969/j.issn.1002-266X.2016.11.006

Abstract：Objective To evaluate the clinical efficacy of computer-assisted minimally invasive technique in treating unstable Hangman's fractures through posterior C 2/3 fixation.Methods Six patients who accepted computer-assisted mini-mally invasive posterior C 2/3 pedicle screw fixation operation were enrolled .Statistics such as operation duration , blood loss, volume of drainage, days in hospital, preoperative, postoperative and follow-up neck disability index (NDI) and vis-ual analogue scale (VAS) , and satisfaction evaluation were recorded .The follow-up CT scans were used to evaluate the fu-sion rate and the follow-up dynamic X-ray was used to assess the fusion and healing condition .Results The operation du-ration was 120-150 min (mean 135 min) .The blood loss was 20-50 mL (average 35 mL) .The days in hospital were 4-10 days (average 6 days).All patients were successfully followed up , with an average of 13.6 months.All patients recovered to E level of ASIA grade when followed up .The preoperative , postoperative and follow-up NDI was 46, 14 and 8, respec-tively.The preoperative, postoperative and follow-up VAS was 8, 1 and 0, respectively.The Macnab criteria are excellent for all the patients.In total, we placed 24 screws.According to Andrew method which is used to evaluate the accuracy of pedicle screw placement , 22 were excellent and 2 were good.Besides, the follow-up dynamic X-ray indicated the atlantoax-ial fracture was well healed .Conclusion The computer-assisted minimally invasive technique in treatment of unstable Hangman's fractures through posterior C 2/3 fixation is safe and effective .