PMC4722693_01
X-ray of the cervical spine showing Hangman's fracture with significant translation and angulation.
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He was placed in a cervical collar and an urgent X-ray of the cervical spine revealed presence of spondylolysthesis of the axis with significant translation and angulation ( Figure 1).
MRI (t2 sequence) of the cervical spine revealing presence of pinching effect but no signal changes in the cord.
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Magnetic resonance imaging (MRI) of the cervical spine revealed a type III hangman's fracture with presence of pinching effect on the cord without any significant signal changes ( Figure 2).
X-ray spine after traction showing realignment of the posterior and the spino-laminar lines.
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Since there was good posterior realignment of the spinal lines after traction ( Figure 3) and intra-operatively, we choose the posterior approach only to minimize the added risk of the anterior approach.
CT spine showing projection of screws through lateral mass of C1.
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Lateral mass screws were placed in C1 and C3 ( Figure 4 and Figure 5).
CT spine showing projection of screw through lateral mass of C3.
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Lateral mass screws were placed in C1 and C3 ( Figure 4 and Figure 5).
CT spine reconstruction showing projection and final alignment of the construct.
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A CT spine check after one week revealed good screw purchase ( Figure 6) and good reduction of fracture segment ( Figure 7).
CT spine showing good reduction of the posterior and the spino-laminar lines and normal canal.
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A CT spine check after one week revealed good screw purchase ( Figure 6) and good reduction of fracture segment ( Figure 7).