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Saradhi’s single stage, anterior sequential reduction utilizing C3 for type III hangman’s fracture: A novel technique
BACKGROUND: Levine Edward's Type III Hangman's fractures are highly unstable and in absence of level 1 evidence, the treatment is individualized. A longer cantilever beam can achieve not just reduction of highly displaced fragments but can also provide a stable construct without the need o...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8978851/ https://www.ncbi.nlm.nih.gov/pubmed/35386244 http://dx.doi.org/10.4103/jcvjs.jcvjs_83_21 |
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author | Mudumba, Vijaya Saradhi Pavan, S. Alugolu, Rajesh |
author_facet | Mudumba, Vijaya Saradhi Pavan, S. Alugolu, Rajesh |
author_sort | Mudumba, Vijaya Saradhi |
collection | PubMed |
description | BACKGROUND: Levine Edward's Type III Hangman's fractures are highly unstable and in absence of level 1 evidence, the treatment is individualized. A longer cantilever beam can achieve not just reduction of highly displaced fragments but can also provide a stable construct without the need of global instrumentation. OBJECTIVE: We extrapolated the surgical techniques of the long cantilever beam to this rare group of cohorts for anterior alone, sequential reduction utilizing C3 rather than sacrificing in a single sitting and single approach. MATERIALS AND METHODS: This is a prospective observational study from 2015 to 2019, of all consecutive 10 patients diagnosed and treated as Type III Hangman's fracture in the Department of Neurosurgery. Clinical evaluation and pain scores were recorded in the preoperative assessment. Radiological investigations included plain roentgenograms in anterior-posterior and lateral views, magnetic resonance imaging, and computed tomography scan of the cervical spine. Preoperative cervical traction was placed in all cases for the achievement of facetal reduction. The high cervical extra-pharyngeal approach was utilized for discectomy, bone grafting, reduction, and sequential plating. RESULTS: Complete reduction was achieved in all the cases and none required additional posterior surgery. There was a significant decrease in axial neck pain with complete fusion of the graft, and healing of fracture site. CONCLUSION: The anterior alone approach with a longer cantilever for primary internal stabilization is a technically safe and suitable option for unstable Type III Hangman's fracture. |
format | Online Article Text |
id | pubmed-8978851 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-89788512022-04-05 Saradhi’s single stage, anterior sequential reduction utilizing C3 for type III hangman’s fracture: A novel technique Mudumba, Vijaya Saradhi Pavan, S. Alugolu, Rajesh J Craniovertebr Junction Spine Original Article BACKGROUND: Levine Edward's Type III Hangman's fractures are highly unstable and in absence of level 1 evidence, the treatment is individualized. A longer cantilever beam can achieve not just reduction of highly displaced fragments but can also provide a stable construct without the need of global instrumentation. OBJECTIVE: We extrapolated the surgical techniques of the long cantilever beam to this rare group of cohorts for anterior alone, sequential reduction utilizing C3 rather than sacrificing in a single sitting and single approach. MATERIALS AND METHODS: This is a prospective observational study from 2015 to 2019, of all consecutive 10 patients diagnosed and treated as Type III Hangman's fracture in the Department of Neurosurgery. Clinical evaluation and pain scores were recorded in the preoperative assessment. Radiological investigations included plain roentgenograms in anterior-posterior and lateral views, magnetic resonance imaging, and computed tomography scan of the cervical spine. Preoperative cervical traction was placed in all cases for the achievement of facetal reduction. The high cervical extra-pharyngeal approach was utilized for discectomy, bone grafting, reduction, and sequential plating. RESULTS: Complete reduction was achieved in all the cases and none required additional posterior surgery. There was a significant decrease in axial neck pain with complete fusion of the graft, and healing of fracture site. CONCLUSION: The anterior alone approach with a longer cantilever for primary internal stabilization is a technically safe and suitable option for unstable Type III Hangman's fracture. Wolters Kluwer - Medknow 2022 2022-03-09 /pmc/articles/PMC8978851/ /pubmed/35386244 http://dx.doi.org/10.4103/jcvjs.jcvjs_83_21 Text en Copyright: © 2022 Journal of Craniovertebral Junction and Spine https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Mudumba, Vijaya Saradhi Pavan, S. Alugolu, Rajesh Saradhi’s single stage, anterior sequential reduction utilizing C3 for type III hangman’s fracture: A novel technique |
title | Saradhi’s single stage, anterior sequential reduction utilizing C3 for type III hangman’s fracture: A novel technique |
title_full | Saradhi’s single stage, anterior sequential reduction utilizing C3 for type III hangman’s fracture: A novel technique |
title_fullStr | Saradhi’s single stage, anterior sequential reduction utilizing C3 for type III hangman’s fracture: A novel technique |
title_full_unstemmed | Saradhi’s single stage, anterior sequential reduction utilizing C3 for type III hangman’s fracture: A novel technique |
title_short | Saradhi’s single stage, anterior sequential reduction utilizing C3 for type III hangman’s fracture: A novel technique |
title_sort | saradhi’s single stage, anterior sequential reduction utilizing c3 for type iii hangman’s fracture: a novel technique |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8978851/ https://www.ncbi.nlm.nih.gov/pubmed/35386244 http://dx.doi.org/10.4103/jcvjs.jcvjs_83_21 |
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