Min-invasive surgical treatment for multiple axis fractures: A case report

• Published in: World journal of clinical cases 2019, Vol.7 (7), p.898-902
• Main Authors: Zhu, Xuan-Chen, Liu, Yi-Jie, Li, Xue-Feng, Yan, Han, Zhang, Ge, Jiang, Wei-Min, Sun, Hou-Yi, Yang, Hui-Lin
• Format: Report
• Language: English
• ISSN: 2307-8960; 2307-8960
• DOI: 10.12998/wjcc.v7.i7.898

BACKGROUNDFractures of the axis are commonly seen in spinal injuries. Upper cervical fractures are usually managed conservatively. However, the complications due to long-term external immobilization cannot be ignored. The traditional open surgery has the disadvantages of too much blood loss and soft tissue injury. The aim of our paper is to introduce a minimally invasive surgical treatment for multiple axis fractures. CASE SUMMARYWe report a 40-year-old Chinese male who had severe neck pain and difficult neck movement after falling from 3 meters. X-ray and computed tomography (CT) scan revealed an axis injury consisting of an odontoid Type III fracture associated with a Hangman fracture categorized as a Levine-Edwards Type I fracture. The patient underwent anterior odontoid screw fixation and posterior percutaneous screw fixation using intraoperative O-arm navigation. Neck pain was markedly improved after surgery. X-rays and CT scan reconstructions of 3-mo follow-up showed good stability and fusion. The range of cervical motion was well preserved. CONCLUSIONAnterior odontoid screw fixation and posterior direct C2 percutaneous pedicle screw fixation with the aid of O-arm navigation and neurophysiological monitoring can be an interesting alternative option for complicated multiple axis fractures.