{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:34:27Z","timestamp":1753893267068,"version":"3.41.2"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,11,26]],"date-time":"2021-11-26T00:00:00Z","timestamp":1637884800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p><jats:bold>Purpose:<\/jats:bold> To compare the effect between C2 spinous muscle complex graft and iliac bone graft in C2-3 pedicle screw fixation for instable Hangman fracture. Using axial spinous muscle complex instead of iliac bone for instable Hangman fracture can decrease neck pain, bone donor site complication, and operation time.<\/jats:p><jats:p><jats:bold>Method:<\/jats:bold> The outcomes of C2-3 pedicle screw fixation with C2 spinous muscle complex were compared with iliac bone graft in 18 and 21 patients with instable Hangman fracture. The mean age was 49.1 \u00b1 15.8 years in the complex group and 55.3 \u00b1 12.2 years in the Iliac group, and the mean time to surgery of the patients was 3.3 \u00b1 0.6 days in the complex group and 3.6 \u00b1 0.9 days in the iliac group. Outcome measures including operation time, blood loss, visual analog scale (VAS) for pain, Japanese orthopedic association score (JOA), American spine injure association classification (ASIA), and bone fusion time were collected from medical records. In addition, the postoperative complications were also recorded.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> There were significant differences in operation time and interoperative blood loss between the two groups (<jats:italic>P<\/jats:italic> &amp;lt; 0.01). Also a significant difference was found in VAS score and JOA score between the two groups (<jats:italic>P<\/jats:italic> = 0.0012 and <jats:italic>P<\/jats:italic> &amp;lt; 0.001, respectively) at 1-month follow-up, whereas, no significant difference was found at other visit time. In the final visit, all patients showed good bone fusion, and two patients shows incision edema and exudation in the iliac group.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> C2-3 pedicle screw fixation with C2 spinous muscle complex graft maybe a feasible and safe procedure for instable Hangman fracture.<\/jats:p>","DOI":"10.3389\/fsurg.2021.723078","type":"journal-article","created":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T05:23:55Z","timestamp":1638336235000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparison of C2-3 Pedicle Screw Fixation With C2 Spinous Muscle Complex and Iliac Bone Graft for Instable Hangman Fracture"],"prefix":"10.3389","volume":"8","author":[{"given":"Dingli","family":"Xu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaifeng","family":"Gan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yulong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weihu","family":"Ma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,11,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"141","DOI":"10.3171\/jns.1965.22.2.0141","article-title":"\u201cHangman's fracture\u201d of the cervical spine","volume":"22","author":"Schneider","year":"1965","journal-title":"J Neurosurg."},{"key":"B2","doi-asserted-by":"publisher","first-page":"217","DOI":"10.2106\/00004623-198567020-00007","article-title":"The management of traumatic spondylolisthesis of the axis","volume":"67","author":"Levine","year":"1985","journal-title":"J Bone Joint Surg Am Vol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1016\/j.clineuro.2018.03.024","article-title":"Multiplanar realignment for unstable Hangman's fracture with Posterior C2-3 fusion: a prospective series","volume":"169","author":"Salunke","year":"2018","journal-title":"Clin Neurol Neurosurg."},{"key":"B4","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1097\/01.brs.0000251917.83529.0b","article-title":"Hangman's fracture: a biomechanical comparison of stabilization techniques","volume":"32","author":"Duggal","year":"2007","journal-title":"Spine."},{"key":"B5","doi-asserted-by":"publisher","first-page":"222","DOI":"10.11607\/jomi.2603","article-title":"Donor site complications in bone grafting: comparison of iliac crest, calvarial, and mandibular ramus bone","volume":"28","author":"Scheerlinck","year":"2013","journal-title":"Int J Oral Maxillofac Implants."},{"key":"B6","doi-asserted-by":"publisher","first-page":"267","DOI":"10.4103\/0976-3147.153237","article-title":"Myoarchitectonic advancement of the C2 spinous process for C1-C2 posterior fusion: a novel technique","volume":"6","author":"Sinha","year":"2015","journal-title":"J Neurosci Rural Pract."},{"key":"B7","doi-asserted-by":"publisher","first-page":"927","DOI":"10.3760\/cma.j.issn.0253-2352.2018.15.005","article-title":"The effects of axial spinous process-muscle-vascellum complex transplantation for posterior atlantoarial fusion","volume":"15","author":"Ma","year":"2018","journal-title":"Chin J Orthop."},{"key":"B8","first-page":"871","article-title":"Efficacy comparison of posterior atlantoaxial screw-rod fixation combined with spinous process muscle-vessel complex bone graft or iliac bone graft for atlantoaxial instability","volume":"10","author":"Xu","year":"2019","journal-title":"Chin J Trauma."},{"key":"B9","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1055\/s-0033-1341606","article-title":"Neck pain following cervical laminoplasty: does preservation of the C2 muscle attachments and\/or C7 matter?","volume":"4","author":"Riew","year":"2013","journal-title":"Evid Based Spine Care J."},{"key":"B10","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1136\/ard.40.1.87","article-title":"Reproducibility along a 10 cm vertical visual analogue scale","volume":"40","author":"Dixon","year":"1981","journal-title":"Ann Rheum Dis."},{"key":"B11","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1007\/s00586-016-4660-8","article-title":"The modified Japanese orthopaedic association scale: establishing criteria for mild, moderate and severe impairment in patients with degenerative cervical myelopathy","volume":"26","author":"Tetreault","year":"2017","journal-title":"Eur Spine J."},{"key":"B12","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1302\/0301-620X.63B3.7263741","article-title":"Fractures of the ring of the axis. 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