Pars screw fixation of a hangman's fracture: technical case report.

OBJECTIVE AND

IMPORTANCE

Traumatic spondylolisthesis of the axis may be treated by external immobilization or surgical fixation.

CLINICAL PRESENTATION: We report the case of a 23-year-old man who sustained an Effendi Type II fracture of the axis, for which halo immobilization did not provide adequate stability.

INTERVENTION: The unstable fracture was treated by placing lag screws in the pars interarticularis of C2, which reduced the fracture directly but sacrificed no normal spinal motion. The patient developed a solid fusion, and cervical alignment was normal at his 6-month follow-up examination.

CONCLUSION

Although this technique has been reported previously, it is more commonly used in multilevel cervical fusions than for stand-alone repair of C2. Management options, anatomy, and technical considerations for the treatment of traumatic spondylolisthesis are reviewed.