Analysis of the clinical characteristics and predisposing factors for neurological deficit with Hangman fractures

Hangman fractures, a common upper cervical spine injury, can sometimes lead to neurological deficits. This study investigates the clinical characteristics and risk factors associated with these deficits. The study involved reviewing data from 97 patients with Hangman fractures, dividing them into those with and without neurological deficits to identify potential risk factors. The research found that a combination of posterior vertebral wall (PVW) fractures and significant translation or angulation of C2/3 vertebrae is a predisposing factor for neurological deficits in Hangman fractures.

• 1
  Neurological deficits after Hangman fractures often present as partial impairments, with varying symptoms such as central spinal cord syndrome, quadriplegia, paresthesia, or monoparesis.
• 2
  MRI scans revealed spinal cord signal changes in patients with neurological deficits, located at the C2–C3 disc level, C2 level, or both.
• 3
  The combination of PVW fractures with ≥ 1.8 mm of translation or ≥ 5.5° of angulation of C2/3 was identified as a predisposing factor for neurological deficit.