Anterior cervical arthrodesis for chronic hangman’s fracture in a patient with osteopetrosis: a case report

Introduction: Osteopetrosis is a clinical syndrome characterized by the failure of osteoclasts to resorb bone. Affected patients usually suffer from repetitive fractures due to this pathological state. Surgical treatment of these fractures is often complicated by the difficulty of working with the extremely hard and brittle bones. The purpose of this study was to report a case of chronic hangman’s fracture in a patient with osteopetrosis who underwent surgery for cervical anterior interbody fusion. Materials and methods: A 76-year-old woman visited our institute 1 month after injury. Radiographs revealed a type II hangman’s fracture with severe translation according to the Levine–Edwards classification. We performed anterior spinal arthrodesis from C2 to C3. Results: We obtained successful anterior C2–C3 arthrodesis without major complications, but encountered some surgical difficulties in treatment due to hard and brittle bones. Conclusions: Anterior cervical arthrodesis can be considered an effective treatment for chronic unstable hangman’s fracture in patients with osteopetrosis. However, great care must be taken when performing surgery and continued follow-up is warranted.