{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:18:04Z","timestamp":1787847484805,"version":"build-2784847793"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Fractures of the upper cervical spine are often but not always amenable to either internal fixation or conservative management using a rigid cervical collar. For all other fractures in this area, management with a halo-vest orthosis is indicated, but it also has limitations. Here, we present an operative alternative to the halo-vest orthosis that provides more secure stability and less complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Three patients presented to our hospital with atypical fractures of C1 and C2 and were given the choice of either a halo-vest orthosis or secure internal fixation without fusion and accepted the latter. Internal fixation without fusion from occiput to the subaxial spine was performed for all three and then removed-6 months later -after radiologic confirmation of healing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>All three patients underwent the procedure successfully and achieved and maintained acceptable alignment. Range of motion was preserved, and no intermediate-term issues were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Spanning internal fixation provides a safe and effective technique in the management of complex upper cervical spine injuries without the drawbacks of using a halo-vest orthosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jcvjs.jcvjs_118_20","type":"journal-article","created":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T09:28:56Z","timestamp":1614763736000},"page":"10-14","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Temporary spanning internal fixation for management of complex upper cervical spine fractures"],"prefix":"10.4103","volume":"12","author":[{"given":"Khalid","family":"AlSaleh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muteb","family":"Abulras","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osama","family":"Alrehaili","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-3-20240904","doi-asserted-by":"crossref","first-page":"e427","DOI":"10.1016\/j.wneu.2017.11.011","article-title":"Traumatic Fractures of the Cervical Spine: Analysis of Changes in Incidence, Cause, Concurrent Injuries, and Complications Among 488,262 Patients from 2005 to 2013","volume":"110","author":"Passias","year":"2018","journal-title":"World Neurosurg"},{"key":"R2-3-20240904","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1007\/s00586-010-1507-6","article-title":"Type II odontoid fractures in the elderly: An evidence-based narrative review of management","volume":"20","author":"Pal","year":"2011","journal-title":"Europ Spine J"},{"key":"R3-3-20240904","doi-asserted-by":"crossref","first-page":"E1206","DOI":"10.1097\/BSD.0000000000000483","article-title":"Halo-vest immobilization in elderly odontoid fracture patients: Evolution in treatment modality and in-hospital outcomes","volume":"30","author":"DePasse","year":"2017","journal-title":"Clin Spine Surg"},{"key":"R4-3-20240904","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1097\/01.ta.0000197426.72261.17","article-title":"Halo-vest immobilization increases early morbidity and mortality in elderly odontoid fractures","volume":"60","author":"Tashjian","year":"2006","journal-title":"J Trauma"},{"key":"R5-3-20240904","doi-asserted-by":"crossref","first-page":"648","DOI":"10.3349\/ymj.2010.51.5.648","article-title":"Optimal use of the halo-vest orthosis for upper cervical spine injuries","volume":"51","author":"Shin","year":"2010","journal-title":"Yonsei Med J"},{"key":"R6-3-20240904","doi-asserted-by":"crossref","first-page":"e10281","DOI":"10.1097\/MD.0000000000010281","article-title":"Surgery vs. conservative treatment for type II and III odontoid fractures in a geriatric population: A meta-analysis","volume":"98","author":"Fan","year":"2019","journal-title":"Medicine"},{"key":"R7-3-20240904","first-page":"31","article-title":"A dynamic compression plate","volume":"125","author":"Perren","year":"1969","journal-title":"Acta Orthop Scand Suppl"},{"key":"R8-3-20240904","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1097\/00005373-197311000-00004","article-title":"The treatment of fractures of the femur in patients with head injuries","volume":"13","author":"Glenn","year":"1973","journal-title":"J Trauma"},{"key":"R9-3-20240904","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1097\/01.bot.0000171881.11205.80","article-title":"Staged management of high-energy proximal tibia fractures (OTA types 41): The results of a prospective, standardized protocol","volume":"19","author":"Egol","year":"2005","journal-title":"J Orthop Trauma"},{"key":"R10-3-20240904","doi-asserted-by":"crossref","first-page":"1578","DOI":"10.1016\/j.jhsa.2006.09.014","article-title":"A biomechanic comparison of an internal radiocarpal-spanning 2.4-mm locking plate and external fixation in a model of distal radius fractures","volume":"31","author":"Wolf","year":"2006","journal-title":"J Hand Surg Am"},{"key":"R11-3-20240904","doi-asserted-by":"crossref","first-page":"1400","DOI":"10.2106\/00004623-196850070-00009","article-title":"The halo. 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