Colamaria Antonio, Carbone Francesco, Leone Augusto, Palmieri Giuseppe, Iodice Savino, Baldassarre Bianca Maria, Cirrottola Giovanni, Ble Valeria, Spetzger Uwe, Di Perna Giuseppe
Division of Neurosurgery, Policlinico "Riuniti" Foggia, University of Foggia, 71122 Foggia, Italy.
Department of Neurosurgery, Karlsruher Neurozentrum, Städtisches Klinikum Karlsruhe, 76133 Karlsruhe, Germany.
Med Sci (Basel). 2025 Jul 19;13(3):92. doi: 10.3390/medsci13030092.
Traumatic fractures of the cervical spine pose significant challenges in management, particularly in young patients, where preserving mobility is crucial.
A 30-year-old woman presented with a C3 lateral mass and pedicle fracture following a motor vehicle collision. Initial conservative management with a rigid cervical collar for three months failed to reduce the diastasis, and the debilitating neck pain worsened. Preoperative imaging confirmed fracture instability without spinal cord compression.
Preoperative screw trajectory planning was conducted with the My Spine MC system (Medacta), and fine-tuning was achieved on a 3D-printed model of the vertebra. A posterior midline approach was employed to expose the C3 vertebra, and a Herbert screw was inserted under fluoroscopic guidance. Imaging at three months demonstrated significant fracture reduction and early bone fusion. The patient achieved substantial improvement in functional mobility without complications.
Herbert screw fixation holds potential as a less-invasive alternative to conventional posterior stabilization for selected cervical fractures. This technical note provides the reader with the required information to support surgical planning and execution.
颈椎创伤性骨折的治疗面临重大挑战，尤其是在年轻患者中，保持颈椎活动度至关重要。
一名30岁女性在机动车碰撞后出现C3侧块及椎弓根骨折。最初采用硬质颈托保守治疗3个月，骨折间隙未缩小，颈部疼痛加剧。术前影像学检查证实骨折不稳定，但无脊髓受压。
使用My Spine MC系统（Medacta）进行术前螺钉轨迹规划，并在椎体的3D打印模型上进行微调。采用后正中入路暴露C3椎体，在透视引导下插入Herbert螺钉。术后3个月影像学检查显示骨折明显复位，早期骨融合。患者功能活动显著改善，无并发症发生。
对于某些颈椎骨折，Herbert螺钉固定作为一种侵入性较小的替代传统后路稳定术的方法具有潜力。本技术说明为读者提供了支持手术规划和实施所需的信息。
