Anterior Cervical Plating for An Axis Tear Drop Fracture: Case Report

Abstract

Axis tear drop fractures are infrequent injuries attributed to hyper extension and flexion of neck. In unstable tear drop fractures there will be posterior displacement of vertebral body, anterior longitudinal ligament disruption and anterior rotation of antero-inferior vertebral body fragment. Most of the unstable tear drop fractures are associated with neurological deficit due to incomplete spinal cord injuries like anterior cord syndrome. We present a case of traumatic unstable C2 flexion tear drop fracture without neurological deficit. We have treated the patient successfully with anterior cervical plating and tricortical bone grafting after removal of tear drop fragment and discectomy. This patient was mobilized on next day after surgery and neck mobilization started after 3 weeks. The patient in our study was followed up for 6 years and found to have no sequlae related to the injury. Unstable tear drop fracture needs to be fixed irrespective of the presence or absence of neurological deficit. Open reduction internal fixation with low profile plate and tricortical bone graft, shaped to fit the defect and disc space, through high anterior retropharyngeal approach is a promising treatment for unstable tear drop fractures.