The aim of the study was to assess the efficacy and safety of direct posterior transpedicular osteosynthesis in traumatic spondylolisthesis of C2 vertebra.
Materials and methods: The present study is an observational retrospective analysis of the results of surgical treatment of 19 patients operated on in 2014-2020 using the posterior transpedicular osteosynthesis technique with Herbert's compression screws for a Hangman's fracture type II according to Levine-Edwards classification. After the operation, the follow-up period lasted for 22 [10; 36] months.
Results: The study group of patients (n=19) made 2.48% of all patients operated on for traumatic injury of the cervical spine (n=766) in the period from 2014 to 2020. In all cases, the surgical treatment was successful; there were no intraoperative complications in the form of damage to the vascular and nerve structures. The average duration of surgery was 70.8±24.5 min, and intraoperative blood loss was 92.9±41.8 ml. The length of hospitalization stay was 7 [5; 17] days. On the postoperative CT scans, no significant screw malposition (>2 mm) was found.
Conclusion: Transpedicular osteosynthesis with compression screws in C2 traumatic spondylolisthesis is a safe and sparing operation with a short duration and insignificant blood loss. Thorough preoperative planning and knowledge of the anatomic landmarks make it possible to perform this operation effectively under the C-arm X-ray system control without any navigation system.
Keywords: C2 fracture; Hangman’s fracture; Judet operation; spinal cord injury; transpedicular fixation; upper cervical spine injury.