Posterior c1-2 Pedicle Screws Fixation for the Treatment of Unstable Complex c2 Fractures: Our Experience

Introduction: Posterior fixation for complex C2 fracture with instability is a very good method with excellent outcome.

Methods: A total of 9 patients were included in the study (8 males and 1 female). Their age ranged from 43 to 76 years. The patients were diagnosed with complex fractures of the axis of the upper cervical spine and underwent posterior C1-2 pedicle screws fixation. The patients underwent a serial postoperative clinical examination at approximately 3, 6, 9 months, and annually thereafter. The neck disability index (NDI) and the range of neck rotary motion were used to evaluate the postoperative clinical efficacy of the patients.

Results: : The mean follow-up was 1-3 years. The average operation time and blood loss were 105-150 min and 50-75 ml, respectively. The neck disability index was improving after surgery to a great extent. The patients with myelopathy (specifically in old C2 fracture with cord compression) also showed significant improvement as assessed by Nurick grading.

Conclusion : Posterior screw fixation is a good surgical treatment option for unstable complex C2 fractures.