C2 Fracture aka Dens fracture, Odontic fracture, Hangman’s Fracture
Innovation in Treatment by Prof. Dr. Bertagnoli
In this most serious of all fractures, either surgery is performed immediately or the patient is put into a Halo collar for six months in the hopes the fracture will fuse on its own. Should the patient be put in a Halo collar there is no guarantee the break will heal or fuse to other vertebrae. Treatment in a Halo collar is not without possible complications such as a partial healing of the bone, known as pseudarthrosis, unintended fusions and muscular atrophy, let alone the misery the patient experiences being in a halo collar. If the fracture does not heal completely, then a surgery will be necessary, unless the patient wishes to live in a Halo collar the rest of their life.
Note: In such fractures damage to the c1 vertebra and the c23 disc are often seen.
While the undisputed surgical treatment for such a fracture is fusion, the question before the surgeon and patient is how to do the fusion. Of course, that depends on the case. Both dorsal and ventral or a combination of dorsal and ventral procedures are available to the surgeon.
Prof. Dr. Bertagnoli has developed an innovative anterior approach for fusing the fracture. Using special tools that he has created he can approach the c2 vertebra below the mandible. This avoids the complications (such as sepsis) of the traditional transoral (through the mouth) approach and leaves the patient with a better post-op experience. Also, Prof. Dr. Bertagnoli will customize the fusion plate for such a surgery, if necessary.
Surgery in this segment of the spine is considered more risky than other segments of the spine.
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