Anterior cervical fixation in type-II traumatie spondylolisthesis of the axis : a report of eighteen cases, and diseussing the rationale of management

الملخص EN

Introduction: Most traumatic spondylolisthesis of the axis fractures are treated conservatively.

If surgery is indicated, an anterior approach using a C2/C3 graft and plate fusion is usually preferred.

Direct transpedicular osteosynthesis according to Judet though a physiological operation that creates anatomical conditions caries a high risk of spinal cord damage or vertebral artery tear.

The treatment choices depend basically on Effindi's fracture typing and Francis' fracture grading.

Methods/Results: Eighteen adult consecutive patients with type-II traumatic spondylolisthesis of the axis were included retrospectively in this study.

The average age was 32.5 years.

Fourteen were males and 4 were females.

The cause of in]ury in all patients was a road traffic accident but in 2 patients was a fell.

Freoperatively, all patients were neurologically intact but two; one was tetra paretic, the other one was atypical Brown Sequard's syndrome.

Associated head trauma Was reported in 5 patients, and other cervical fractures in 5 patients.

All patients were treated primarily with anterior C2/C3 auto graft and plating after closed reduction.

Reduction was complete and healing was uneventful in all patients.

There were no reported morbidity or mortality.

Hospital stay was ( 8 days in 15 patients including the time of closed reduction.

Both paretic patients recovered with minimal Conclusions.

Froper typing and grading of hangman's fractures is mandatory for a better management.

Early surgical fusion is recommended for hangman's fractures of the Effendi-type II, III.

Anterior plating is a simple effectivechoice fer hangman's fractures.

It shortens hospital stay and skeletal tractions time.