A novel technique using a pedicle screw and bucking bar for the treatment of hangman's fracture

Abstract The treatment of hangman's fracture is controversial. If treated with a traditional surgical procedure, there will likely be many complications, such as kyphosis, pseudarthrosis and nonunion. Our present study aims to describe a bucking bar method with pedicle screw fixation to treat hangman's fracture. Thirty-two patients with an unstable hangman's fracture who underwent posterior C2-3 pedicle lag screw fixation surgery assisted by a bucking bar between May 2004 and Jan 2017 were evaluated. All the participating patients were successfully treated using this novel technique, and follow-up revealed anatomical fusion in 27 patients, incomplete fusion in 4 patients, and C2-3 angular deformity healing in 1 patient. No patient developed throat wall edema or pseudomembrane formation. Satisfactory reduction, fixation and fusion of C2 pedicle fractures can be achieved using a pedicle screw assisted with the transoral bucking bar technique. Level of evidence IV, retrospective case-series study.