Intraoperative color-coded duplex ultrasound for safe surgical reduction of displaced hangman fractures in patients with atypical course of the vertebral artery: A case report of two patients

• DOI: 10.1016/j.tcr.2021.100573
• Publication Date: 2021-12-09T07:17:58Z
• Authors: Katharina A.C. Os...; Moritz C. Deml; Mirjam R. Heldner; David Seiffge; Sebastian F. Bigdon; Christoph E. Albers
• Keywords: RD1-811; 610 Medicine & health; Case Report; Atypical course vertebral artery; Spine; 3. Good health; 03 medical and health sciences; Spine surgery; 0302 clinical medicine; Cervical spine; Duplex ultrasound; Surgery; Hangman fracture

An atypical course of the vertebral artery can be medically relevant in displaced Hangman fractures, especially if runs within fracture gap C2 isthmus. During surgical reduction, occluded inside fracture, potentially leading to ischemic conditions brain. The aim this study was report two cases according CARE (case reporting) guidelines, which intraoperative color-coded duplex-ultrasound performed secure safe reduction hangman fractures patients with an artery. Two (Effendi-Levine type II) were diagnosed running gap. This endangered management risk iatrogenic occlusion or injury during through entrapment vessel Therefore, conducted before and after as well at end surgery. treatment both included posterior unilateral spondylodesis, followed by anterior cervical discectomy fusion (ACDF). In patients, a performed. Neither nor dissection occurred. duplex ultrasound procedure showed normal blood flow morphology arteries. At follow-up examinations, favorable clinical outcome, radiographic signs fusion, no irregularity case serves proof-of-concept, demonstrating feasibility regimen minimize