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Journal of Craniovertebral Junction and Spine
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Year : 2021  |  Volume : 12  |  Issue : 1  |  Page : 10-14

Temporary spanning internal fixation for management of complex upper cervical spine fractures

Department of Orthopedics College of Medicine, King Saud University, Riyadh, Saudi Arabia

Correspondence Address:
Khalid AlSaleh
Department of Orthopedics, College of Medicine, King Saud University, Riyadh 12372
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcvjs.JCVJS_118_20

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Introduction: Fractures of the upper cervical spine are often but not always amenable to either internal fixation or conservative management using a rigid cervical collar. For all other fractures in this area, management with a halo-vest orthosis is indicated, but it also has limitations. Here, we present an operative alternative to the halo-vest orthosis that provides more secure stability and less complications. Methods: Three patients presented to our hospital with atypical fractures of C1 and C2 and were given the choice of either a halo-vest orthosis or secure internal fixation without fusion and accepted the latter. Internal fixation without fusion from occiput to the subaxial spine was performed for all three and then removed-6 months later -after radiologic confirmation of healing. Results: All three patients underwent the procedure successfully and achieved and maintained acceptable alignment. Range of motion was preserved, and no intermediate-term issues were observed. Conclusion: Spanning internal fixation provides a safe and effective technique in the management of complex upper cervical spine injuries without the drawbacks of using a halo-vest orthosis.

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