Asian Spine J.  2012 Sep;6(3):194-198. 10.4184/asj.2012.6.3.194.

Percutaneous Pedicle Screw Fixation of a Hangman's Fracture Using Intraoperative, Full Rotation, Three-dimensional Image (O-arm)-based Navigation: A Technical Case Report

• Yoshida G
• Kanemura T
• Ishikawa Y

• KMID: 2270459
• DOI: http://doi.org/10.4184/asj.2012.6.3.194

Abstract

Surgical treatment of a hangman's fractures is technically demanding, even when using the standard open procedure. In this case report, a type II hangman's fracture was treated by percutaneous posterior screw fixation, without a midline incision, using intraoperative, full rotation, three-dimensional (3D) image (O-arm)-based navigation. A 48-year-old woman was injured in a motor vehicle accident and diagnosed with a unilateral hangman's fracture associated with subluxation of the C2 vertebral body on C3. After attaching the reference arc of the 3D-imaging system to the headholder, the cervical spine was screened using an O-arm without anatomical registration. Drilling and screw fixation were performed using a guide tube while referring to the reconstructed 3D-anatomical views. The operation was successfully completed without technical difficulties or neurovascular complications. This percutaneous procedure requires less dissection of normal tissue, which may allow earlier recovery. However, further validation of this procedure for its effectiveness and safety is required.

Keyword

Pedicle screw; Percutaneous; Minimally invasive; Hangman's fracture; Three-dimensional image-based navigation

MeSH Terms

Female
Humans
Imaging, Three-Dimensional
Mandrillus
Middle Aged
Motor Vehicles
Spine