Current Concepts in the Treatment of Traumatic C2 Vertebral Fracture : A Literature Reviewopen access
- Authors
- Lee, Subum; Hur, Junseok W.; Oh, Younggyu; An, Sungjae; Yun, Gi-Yong; Ahn, Jae-Min
- Issue Date
- Jan-2024
- Publisher
- 대한신경외과학회
- Keywords
- Cervical vertebra axis; Hangman's fracture; Odontoid process; Spinal injuries; Spinal fractures
- Citation
- Journal of Korean Neurosurgical Society, v.67, no.1, pp 6 - 13
- Pages
- 8
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- Journal of Korean Neurosurgical Society
- Volume
- 67
- Number
- 1
- Start Page
- 6
- End Page
- 13
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/65436
- DOI
- 10.3340/jkns.2023.0098
- ISSN
- 2005-3711
1598-7876
- Abstract
- The integrity of the high cervical spine, the transition zone from the brainstem to the spinal cord, is crucial for survival and daily life. The region protects the enclosed neurovascular structure and allows a substantial portion of the head motion. Injuries of the high cervical spine are frequent, and the fractures of the C2 vertebra account for approximately 17-25% of acute cervical fractures. We review the two major types of C2 vertebral fractures, odontoid fracture and Hangman's fracture. For both types of fractures, favorable outcomes could be obtained if the delicately selected conservative treatment is performed. In odontoid fractures, as the most common fracture on the C2 vertebrae, anterior screw fixation is considered first for type II fractures, and C1-2 fusion is suggested when nonunion is a concern or occurs. Hangman's fractures are the second most common fracture. Many stable extension type I and II fractures can be treated with external immobilization, whereas the predominant flexion type IIA and III fractures require surgical stabilization. No result proves that either anterior or posterior surgery is superior, and the surgeon should decide on the surgical method after careful consideration according to each clinical situation. This review will briefly describe the basic principles and current treatment concepts of C2 fractures.
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