Nagashima Yoshitaka, Nishimura Yusuke, Matsuo Mamoru, Tanei Takafumi, Saito Ryuta
Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, JPN.
Cureus. 2023 Jul 26;15(7):e42510. doi: 10.7759/cureus.42510. eCollection 2023 Jul.
There are various types of C2 fractures, including odontoid fractures, hangman fractures, and complex fractures, which involve the vertebral body or multiple fracture types. The published literature on C2 complex fractures is limited, and treatment strategies have not yet been established. An 80-year-old woman with a history of osteoporosis, brain stroke, and cervical spondylosis fell and sustained a C2 complex fracture. Initial treatment with a cervical collar was unsuccessful and a C2 direct screw osteosynthesis surgery was performed under an image-guided three-dimensional navigation system. The surgical procedure was successfully performed with a surgical time of 83 minutes and a blood loss of 31 ml. Her neck pain improved after surgery. Follow-up CT scans revealed acceptable healing of the fracture four months later. C2 direct screw osteosynthesis is a viable treatment option for C2 complex fractures, particularly in elderly patients who may benefit from early stabilization of the fracture to prevent complications associated with long-term conservative treatment.
C2骨折有多种类型，包括齿突骨折、绞刑者骨折和复杂骨折，后者累及椎体或多种骨折类型。关于C2复杂骨折的已发表文献有限，治疗策略尚未确立。一名80岁女性，有骨质疏松、脑卒中和颈椎病病史，跌倒后发生C2复杂骨折。最初使用颈托治疗失败，遂在影像引导三维导航系统下行C2直接螺钉内固定手术。手术顺利完成，手术时间83分钟，失血31毫升。术后她的颈部疼痛改善。术后4个月的随访CT扫描显示骨折愈合良好。C2直接螺钉内固定是治疗C2复杂骨折的一种可行选择，特别是对于老年患者，他们可能受益于骨折的早期稳定，以预防与长期保守治疗相关的并发症。
