Anterior cervical fixation in type-II traumatic spondylolisthesis of the axis: a report of eighteen cases, and discussing the rationale of management

Eighteen adult consecutive patients with type-II traumatic spondylolisthesis of the axis were included retrospectively in this study. The average age was 32.5 years. Fourteen were males and 4 were females. The cause of injury in all patients was road traffic accident but in 2 patients was a fall. Preoperatively, all patients were neurologically intact except two; one was tetra paretic and the other one was atypical brown Sequard's syndrome. Associated head trauma was reported in 5 patients and other cervical fractures in 5 patients. All patients were treated primarily with anterior C2/C3 auto graft and plating after closed reduction. Reduction was complete and healing was uneventful in all patients. there plating after closed reduction. There were no reported morbidity or mortality. Hospital stay was 8 days in 15 patients including the time of closed reduction. Both paretic patients recovered with minimal gait difficulty. Proper typing and grading of hangman's fractures is mandatory for a better management. Early surgical fusion is recommended for hangman's fractures of the effendi-type II and III. Anterior plating is a simple effective choice for hangman's fractures. It shortens hospital stay and skeletal tractions time