Epidural hematoma after immobilization of a "hangman's" fracture: Case report and review of the literature

Jacob M. Buchowski, Lee H. Riley

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Background context: Neurologic deterioration after immobilization of traumatic spondylolisthesis of the axis rarely occurs because of the decompressive nature of the injury itself and the large amount of space available for the cord in the upper cervical spine. Purpose: To document neurologic deterioration after reduction (without the use of traction) and halo immobilization of a Type IIA traumatic spondylolisthesis of the axis (hangman's fracture) secondary to an epidural hematoma. Study design/setting: Case report. Patient sample and outcome measures: The patient population consisted of one patient; no outcome measures were used. Methods: The medical record and radiographic studies of a 27-year-old patient involved in a motor vehicle crash that resulted in a traumatic spondylolisthesis of the axis were retrospectively reviewed, and a review of the English literature was performed. Results: Upon evaluation, the patient was found to have, in addition to other injuries, a Type IIA hangman's fracture of the C2 vertebra, which was stabilized in a halo. Shortly thereafter, the patient developed a gradual progressive neurologic deficit. Magnetic resonance imaging revealed the presence of a large epidural hematoma with cord compression treated with posterior laminectomy and transdural decompression of an anterior hematoma. Postoperatively, the patient's neurologic examination improved and returned to normal within 6 months. Conclusion: An epidural hematoma can occur after traumatic spondylolisthesis of the axis, but its symptoms may not present until after the spondylolisthesis is treated.

Original languageEnglish
Pages (from-to)332-335
Number of pages4
JournalSpine Journal
Volume5
Issue number3
DOIs
StatePublished - May 1 2005
Externally publishedYes

Keywords

  • Axis
  • Hangman's fracture
  • Spine
  • Traumatic spondylolisthesis

Fingerprint Dive into the research topics of 'Epidural hematoma after immobilization of a "hangman's" fracture: Case report and review of the literature'. Together they form a unique fingerprint.

  • Cite this