Clinical Effect of Bone Grafting Fusion and Internal-fixation by the Anterior-Cervical Approach for Hangman Fracture of Type Ⅱ and Ⅱ A

Abstract：Objective To explore the operation strategy and the clinical effect of the treatment of bone grafting and fusion together with internal fixation by the Anterior-Cervical approach for Hangman type Ⅱ and Ⅱ A fractures .Meth-ods 16 cases of patients with Hangman fracture in our hospital from March 2010 to June 2016 were analyzed retro-spectively .There were 12 cases of type Ⅱ and 4 cases of type Ⅱ A according to the rule of Levine-Edwards .11 patients were male and 5 patients were female ,aged from 23 to 56 years old with an average of 38 .3 years old .The 12 patients with type Ⅱ fracture received the preoperative Skull-Traction-Reduction .The other 4 patients were only immobilized with the cervical gear .All the 16 patients underwen excision of C 2 ～ 3 intervertebral disk by the anterior cervical approach and autogeneic ilium implantation or interbody fusion cage with Titanium plate internal fixation .2 of them received the decompressive resection of posterior longitudinal ligament .Results None of the 16 patients suffered from any complica-tions like injuries in vessels ,nerves or esophagus .The cervical pain was markedly alleviated .The preoperative VAS sco-ring was 6 .1 points compared to the postoperative counterpart of 2 .3 points .All the patients gained anatomic reattach-ment in the axis ,which is confirmed by the X-ray examination .The locations of the internal fixation were good .There were no any loosening or rupture .The postoperative follow-up in 6 to 18 months revealed that all the cases had a bony fusion after the bone grafting at the cervical C 2 ～ 3 level .Conclusion The treatment of bone grafting and fusion together with internal fixation by the Anterior-Cervical approach is a good choice for Hangman type Ⅱ and Ⅱ A fractures be-cause of the good reduction ,firm fixation and the high rate of bony fusion of the bone grafting .Therefore ,it is a safe ,re-liable and effective treatment .