Abstract
Purpose of study
The vast majority of C2 ring fractures can be managed non-operatively but occasionally the situation precludes this and surgery is considered. Thus study reviews our indications and surgical options in this scenario.
Methods
A retrospective review of patient folders and x-rays was performed of all patients with C2 traumatic spondylolisthesis that were managed surgically between 2003 and 2012.
Demographic data, particularly indications for surgery, the options chosen and the clinical and radiological outcomes were analysed.
Results
Six patients required surgery for a Traumatic Spondylolisthesis of the Axis during this period. Of these 6 cases, 2 were performed for failure of conservative treatment and the other 4 for associated injuries or condition (pregnancy). A variety of surgical methods were utilised including pars repair, C2-C2 posterior fusion and combined anterior C2/3 plating with posterior C1-3 fixation.
Osseous healing was achieved in all patients in less than 6 months. There was one case that presented at 3 months post op with an adjacent level subluxation that required application of cones callipers until bony union. There were no infective complications, and no deterioration of neurological findings.
Conclusion
Although the majority of Traumatic Spondylolisthesis of the Axis can be managed non-operatively, there are occasional non-spinal reasons to consider surgical stabilisation. There are many options but we would recommend a C2/3 fusion rather than pars repair due to the C2/3 disc trauma and inevitable ankylosis. This can be effectively performed from a posterior approach.
NO DISCLOSURES
