{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:43:34Z","timestamp":1787755414869,"version":"build-2784847793"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>A 48-year-old man fell from a tree and presented to the emergency department with right-sided full hemiplegia and C3 bilateral hypoesthesia. Imaging was remarkable for a C2-C3 fracture-dislocation. The patient was effectively managed surgically with a posterior decompression and 4-level posterior cervical fixation\/fusion that included pedicle screws in the axis fixation and lateral mass screws. The reduction\/fixation remained stable, and the patient regained full lower extremity function and demonstrated functional upper-extremity recovery at three-year follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>C2-C3 fracture-dislocation is a rare but potentially fatal injury due to concomitant spinal cord injury, and its surgical management can be challenging because of the proximity of vascular and nerve structures. Posterior cervical fixation that includes axis pedicle screws can be an effective fixation option in select patients with this condition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.22.00337","type":"journal-article","created":{"date-parts":[[2023,3,3]],"date-time":"2023-03-03T14:04:43Z","timestamp":1677852283000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Pedicle Screw Fixation for Hemiplegia and Bilateral Hypoesthesia Due to C2-C3 Spinal Fracture Dislocation"],"prefix":"10.2106","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7536-8825","authenticated-orcid":false,"given":"IGLNA Artha","family":"Wiguna","sequence":"first","affiliation":[{"name":"Department of Orthopedic and Traumatology, Faculty of Medicine Udayana University \/ Sanglah General Hospital, Bali, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8837-1428","authenticated-orcid":false,"given":"I Ketut","family":"Suyasa","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Traumatology, Faculty of Medicine Udayana University \/ Sanglah General Hospital, Bali, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7566-6980","authenticated-orcid":false,"given":"Hans K","family":"Nugraha","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Traumatology, Faculty of Medicine Udayana University \/ Sanglah General Hospital, Bali, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,1]]},"reference":[{"issue":"3","key":"bib1-20240731","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/j.spinee.2017.07.175","article-title":"Traumatic subaxial cervical facet subluxation and dislocation: epidemiology, radiographic analyses, and risk factors for spinal cord injury","volume":"18","author":"Quarrington","year":"2018","journal-title":"Spine J."},{"key":"bib2-20240731","first-page":"e5538","article-title":"C2-3 fracture dislocation and bilateral vertebral artery occlusion without neurological injury: a case report","volume":"11","author":"Kiessling","year":"2019","journal-title":"Cureus."},{"issue":"2","key":"bib3-20240731","doi-asserted-by":"crossref","first-page":"S74","DOI":"10.1097\/PHM.0000000000000660","article-title":"People with spinal cord injury in Indonesia","volume":"96","author":"Tulaar","year":"2017","journal-title":"Am J Phys Med Rehabil."},{"issue":"1","key":"bib4-20240731","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1186\/s41983-021-00433-x","article-title":"A demographic profile of cervical injury: an Indonesian single tertiary hospital study with 6 months to 1-year follow-up","volume":"57","author":"Widhiyanto","year":"2021","journal-title":"Egypt J Neurol Psychiatry Neurosurg."},{"issue":"1","key":"bib5-20240731","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1038\/s41394-019-0150-7","article-title":"C2-C3 spinal fracture subluxation with ligamentous and vascular injury: a case report and review of management","volume":"5","author":"Alexander","year":"2019","journal-title":"Spinal Cord Ser Cases."},{"issue":"2","key":"bib7-20240731","doi-asserted-by":"crossref","first-page":"65","DOI":"10.4103\/0974-8237.139200","article-title":"Cervical injuries scored according to the Subaxial Injury Classification system: an analysis of the literature","volume":"5","author":"Joaquim","year":"2014","journal-title":"J Craniovertebr Junction Spine."},{"issue":"11","key":"bib8-20240731","doi-asserted-by":"crossref","first-page":"e2133604","DOI":"10.1001\/jamanetworkopen.2021.33604","article-title":"Effect of early vs delayed surgical treatment on motor recovery in incomplete cervical spinal cord injury with preexisting cervical stenosis: a randomized clinical trial","volume":"4","author":"Chikuda","year":"2021","journal-title":"JAMA Netw Open."},{"key":"bib9-20240731","first-page":"151","article-title":"The management of cervical spine injuries \u2013 a literature review","volume":"13","author":"Okereke","year":"2021","journal-title":"Orthop Res Rev."},{"issue":"20","key":"bib11-20240731","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1001\/jama.1997.03540440031029","article-title":"Administration of methylprednisolone for 24 or 48 hours or tirilazad mesylate for 48 hours in the treatment of acute spinal cord injury. 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