Pars screw fixation of a hangman's fracture: technical case report.

Abstract

Traumatic spondylolisthesis of the axis may be treated by external immobilization or surgical fixation. We report the case of a 23-year-old man who sustained an Effendi Type II fracture of the axis, for which halo immobilization did not provide adequate stability. The unstable fracture was treated by placing lag screws in the pars interarticularis of C2, which reduced the fracture directly but sacrificed no normal spinal motion. The patient developed a solid fusion, and cervical alignment was normal at his 6-month follow-up examination. Although this technique has been reported previously, it is more commonly used in multilevel cervical fusions than for stand-alone repair of C2. Management options, anatomy, and technical considerations for the treatment of traumatic spondylolisthesis are reviewed.