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Ambuj Kumar, Amandeep Kumar, Pankaj Kumar Singh, Shashwat Mishra, Kanwaljeet Garg and Bhawani S. Sharma

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Sanjeev Ariyandath Sreenivasan, Kanwaljeet Garg, Shashwat Mishra, Pankaj Kumar Singh, Manmohan Singh and Poodipedi Sarat Chandra

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Pankaj K. Singh, Mohit Agrawal, Dattaraj Sawarkar, Amandeep Kumar, Satish Verma, Ramesh Doddamani, P. Sarat Chandra and Shashank S. Kale

Hangman’s fracture, also known as traumatic spondylolisthesis of the axis, causes widening of the neural canal and thus a low rate of neurological deficits. This low rate is one of the reasons it is neglected and patients present with late neurological deficits. In an effort to preserve motion at the C1–2 joint, the authors devised a new technique of bilateral C2 pedicle reconstruction. They describe the first two cases in the literature of an old hangman’s fracture with resorbed C2 pedicles due to chronic fracture, in which bilateral C2 pedicles were reconstructed. One of the two cases (case 2) is the first reported case of severe C2–3 spondyloptosis with C2 displaced up to the level of C4. Case 1 had a follow up of 21 months, while case 2 had a follow up of 12 months. Both patients experienced neurological improvement with evidence of fusion and artificial pedicle formation at last follow-up. Bilateral C2 pedicle reconstruction is a feasible technique that can be used with a good outcome in select patients.

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Raman A. Mahalangikar, Pankaj Kumar Singh, Shashwat Mishra and Bhawani Shanker Sharma