Cervical Lateral Mass and Pedicle Fracture Reduced with a Herbert Screw: A Technical Note

TL;DR

A 30-year-old woman with a cervical spine fracture was successfully treated with a Herbert screw, offering a less-invasive alternative to traditional surgery.

Contribution

This paper introduces the use of a Herbert screw for cervical lateral mass and pedicle fractures as a less-invasive surgical option.

Findings

Herbert screw fixation achieved significant fracture reduction and early bone fusion in a 30-year-old patient.

The patient experienced improved functional mobility without complications after the procedure.

Preoperative planning using 3D-printed models and fluoroscopic guidance enhanced surgical precision.

Abstract

Background: Traumatic fractures of the cervical spine pose significant challenges in management, particularly in young patients, where preserving mobility is crucial. Patient Characteristics: A 30-year-old woman presented with a C3 lateral mass and pedicle fracture following a motor vehicle collision. Initial conservative management with a rigid cervical collar for three months failed to reduce the diastasis, and the debilitating neck pain worsened. Preoperative imaging confirmed fracture instability without spinal cord compression. Intervention and Outcome: Preoperative screw trajectory planning was conducted with the My Spine MC system (Medacta), and fine-tuning was achieved on a 3D-printed model of the vertebra. A posterior midline approach was employed to expose the C3 vertebra, and a Herbert screw was inserted under fluoroscopic guidance. Imaging at three months demonstrated significant fracture reduction and early bone fusion. The patient achieved substantial improvement in functional mobility without complications. Conclusion: Herbert screw fixation holds potential as a less-invasive alternative to conventional posterior stabilization for selected cervical fractures. This technical note provides the reader with the required information to support surgical planning and execution.

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