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Background: Anterior C2/3 discectomy and interbody fusion (ACDF) with plating is increasingly performed as the primary treatment of unstable Hangman's fracture; however, plate-related complications, such as screw back-out, plate fracture and soft-tissue injury, is not uncommon. Polyetheretherketone (PEEK) cage has now been developed to provide initial stability before fusion; however, whether and how ACDF with PEEK cage offer better clinical results compared with ACDF with plating in management of Hangman's fracture remains unknown. This study compares the efficacy of ACDF with plating to that of ACDF with PEEK cage in management of type II/IIA Hangman's fractures (according to Levine and Edwards classification) retrospectively.

Methods: From February 2006 to March 2012, a total of 21 patients with type II/IIA Hangman's fractures combined with intervertebral disc injury underwent ACDF with PEEK cage, and 28 patients underwent ACDF with plating. Perioperative parameters were compared. The average follow-up period was 50.3 months (range 27-76 months). The clinical outcome (visual analog scale (VAS), American Spinal Injury Association (ASIA) scale, and clinical post-traumatic neck score (PTNC)) and radiological outcome (translation of C2, local kyphotic angle (LKA), and fusion status of C2/3) was compared retrospectively.

Results: The operative time and blood loss were significantly less in the ACDF with cage group compared with that in the ACDF with plating group (P < 0.05). All patients showed neurological recovery and achieved solid fusion. There were no significant differences in the clinical and radiological outcomes at final follow-up between groups, except in the LKA and the correction loss rate of LKA which were higher in the ACDF with plating group (P < 0.05). Donor-site pain occurred in two patients (10.1%) within 6 months after operation in the ACDF with plating group and none in the ACDF with cage group. All patients recovered without any adverse effects.

Conclusions: ACDF with PEEK cage is effective and reliable in management of type II/IIA Hangman's fractures and is more cost-effective due to shorter operative time and less blood loss requirements.

Titel:	Anterior-only stabilization using cage versus plating with bone autograft for the treatment of type II/IIA Hangman's fracture combined with intervertebral disc injury.
Autor/in / Beteiligte Person:	Wei, F ; Pan, X ; Zhou, Z ; Cui, S ; Zhong, R ; Wang, L ; Gao, M ; Chen, N ; Liang, Z ; Zou, X ; Huang, S ; Liu, S
Link:	Volltext (PDF) View record at Springer (Volltext)
Zeitschrift:	Journal of orthopaedic surgery and research, Jg. 10 (2015-03-11), S. 33
Veröffentlichung:	London : BioMed Central, 2006-, 2015
Medientyp:	academicJournal
ISSN:	1749-799X (electronic)
DOI:	10.1186/s13018-015-0164-1
Schlagwort:	Adult Axis, Cervical Vertebra diagnostic imaging Benzophenones Female Fracture Fixation, Internal adverse effects Fracture Fixation, Internal instrumentation Humans Intervertebral Disc injuries Ketones Male Middle Aged Polyethylene Glycols Polymers Radiography Retrospective Studies Spinal Fractures diagnostic imaging Transplantation, Autologous Treatment Outcome Vertebroplasty Axis, Cervical Vertebra injuries Bone Transplantation Fracture Fixation, Internal methods Internal Fixators Spinal Fractures surgery
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Language: English [J Orthop Surg Res] 2015 Mar 11; Vol. 10, pp. 33. <i>Date of Electronic Publication: </i>2015 Mar 11. MeSH Terms: Bone Transplantation* ; Internal Fixators* ; Axis, Cervical Vertebra / injuries ; Fracture Fixation, Internal / methods ; Spinal Fractures / *surgery ; Adult ; Axis, Cervical Vertebra / diagnostic imaging ; Benzophenones ; Female ; Fracture Fixation, Internal / adverse effects ; Fracture Fixation, Internal / instrumentation ; Humans ; Intervertebral Disc / injuries ; Ketones ; Male ; Middle Aged ; Polyethylene Glycols ; Polymers ; Radiography ; Retrospective Studies ; Spinal Fractures / diagnostic imaging ; Transplantation, Autologous ; Treatment Outcome ; Vertebroplasty References: Spine (Phila Pa 1976). 2000 Oct 15;25(20):2646-54; discussion 2655. (PMID: 11034651) ; Int Orthop. 2010 Feb;34(1):85-8. (PMID: 18853157) ; J Bone Joint Surg Br. 2000 Sep;82(7):1046-52. (PMID: 11041600) ; Spine (Phila Pa 1976). 1996 Mar 1;21(5):614-9. (PMID: 8852318) ; J Spinal Disord Tech. 2007 Dec;20(8):616-9. (PMID: 18046176) ; Spine J. 2008 May-Jun;8(3):426-35. (PMID: 17977799) ; Spine (Phila Pa 1976). 2001 Jan 1;26(1):88-99. (PMID: 11148651) ; Eur Spine J. 2010 Aug;19(8):1299-305. (PMID: 20401619) ; Neurosurgery. 2002 Dec;51(6):1343-49; discussion 1349-50. (PMID: 12445338) ; J Bone Joint Surg Br. 1981;63-B(3):313-8. (PMID: 7263740) ; J Neurosurg. 1989 Nov;71(5 Pt 1):642-7. (PMID: 2809718) ; J Neurosurg. 1996 Aug;85(2):206-10. (PMID: 8755747) ; Spine (Phila Pa 1976). 1999 Feb 1;24(3):295-8. (PMID: 10025026) ; Eur Spine J. 2014 Aug;23(8):1641-7. (PMID: 24756893) ; J Bone Joint Surg Am. 1985 Feb;67(2):217-26. (PMID: 3968113) ; J Spinal Disord. 2000 Feb;13(1):77-84. (PMID: 10710155) ; Clin Orthop Relat Res. 1999 Feb;(359):77-88. (PMID: 10078131) ; J Neurosurg. 1996 Oct;85(4):550-4. (PMID: 8814154) ; Acta Chir Orthop Traumatol Cech. 2006 Oct;73(5):321-8. (PMID: 17140513) ; Neurosurgery. 1992 May;30(5):761-4; discussion 764-5. (PMID: 1584391) ; Eur Spine J. 2011 Nov;20(11):1946-50. (PMID: 21720728) ; Eur Spine J. 2006 Mar;15(3):257-69. (PMID: 16235100) ; Kaohsiung J Med Sci. 2003 May;19(5):208-16. (PMID: 12822677) ; Spine (Phila Pa 1976). 2009 Jun 15;34(14):1429-35. (PMID: 19525832) ; J Bone Joint Surg Am. 1997 Apr;79(4):523-32. (PMID: 9111396) ; J Neurosurg. 1965 Feb;22:141-54. (PMID: 14288425) ; Spine (Phila Pa 1976). 2008 Feb 1;33(3):255-8. (PMID: 18303456) ; Spine (Phila Pa 1976). 2002 Oct 15;27(20):2229-33. (PMID: 12394899) ; Surg Neurol. 1998 Jan;49(1):25-31. (PMID: 9428891) ; Eur Spine J. 2009 Sep;18(9):1293-9. (PMID: 19488794) ; Neurosurgery. 2005 Jan;56(1 Suppl):E204; discussion E204. (PMID: 15799815) ; J Neurosurg Spine. 2013 Nov;19(5):569-75. (PMID: 24033304) ; Eur Spine J. 2009 Feb;18(2):238-43. (PMID: 19130094) ; Spine (Phila Pa 1976). 2011 Apr 1;36(7):529-33. (PMID: 21079544) ; Neurosurgery. 2010 Mar;66(3 Suppl):68-82. (PMID: 20173530) ; Spine J. 2007 Mar-Apr;7(2):205-9. (PMID: 17321970) ; Spine J. 2003 Mar-Apr;3(2):106-17; discussion 117. (PMID: 14589223) ; Spine (Phila Pa 1976). 2011 Jun 15;36(14):E950-60. (PMID: 21522044) ; Eur Spine J. 2011 Oct;20(10):1650-7. (PMID: 21744284) ; Clin Orthop Relat Res. 2002 Jan;(394):47-54. (PMID: 11795751) ; Eur Spine J. 2012 May;21(5):863-71. (PMID: 22109567) ; Spine (Phila Pa 1976). 2000 Jul 1;25(13):1655-67. (PMID: 10870141) ; J Bone Joint Surg Am. 1994 Nov;76(11):1606-16. (PMID: 7962020) ; Exp Ther Med. 2013 Mar;5(3):667-672. (PMID: 23408668) ; Surg Neurol. 1998 Mar;49(3):253-61; discussion 261-2. (PMID: 9508111) ; Spine (Phila Pa 1976). 2000 Oct 15;25(20):2675-81. (PMID: 11034656) Substance Nomenclature: 0 (Benzophenones) ; 0 (Ketones) ; 0 (Polymers) ; 31694-16-3 (polyetheretherketone) ; 3WJQ0SDW1A (Polyethylene Glycols) Entry Date(s): Date Created: 20150417 Date Completed: 20160324 Latest Revision: 20211203 Update Code: 20231215 PubMed Central ID: PMC4362826

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Anterior-only stabilization using cage versus plating with bone autograft for the treatment of type II/IIA Hangman's fracture combined with intervertebral disc injury.