Cases Presentation:

Diagnosis : Unstable fracture dislocation C6-7  with tear of the PLL and ALL

43 years age  patient  was transferred  23.05.1999 . The patient after RTA 26.04.1999 got unstable fracture-dislocation of C6-7 , for what  Hallo traction was applied for reduction of the dislocation, which was proved to be ineffective , when the patient was put in collar and check X-ray done 3 weeks after the traction . The dislocation regained its previous unacceptable position, manifesting that unacceptable instability of the alignment having place.  

Pre-and-postoperative  cervical X-rays demonstrating the reduction and rigid fixation of the C6-7 segment.

The patient was neurologically free  with no other associated injuries. The patient performed MRI and the investigation ruled out the presence of extruded in side disc material . Tear of the ALL and PLL was confirmed, so that the interspinous ligament.

The patient was operated 24.05.1999. Through right-sided anterior approach  with Hallo traction used with weight 10 Kg, the bodies of C6 and 7 were exposed and the disc  C6-7 , which was bulging through the teared ALL  was removed. Using Cloward instrumentation bone  graft 14 mm diameter was harvested from the right iliac bone and a hole 14 mm diameter was created at the disc space and the bone graft fit to it. Using the Codman cervical miniplate 30 mm length  and four screws fusion of the body of C6 and 7 was performed . Additional screw was used to secure the bone graft to the fixing device ( as seen in the fig. ) . Postoperative period was uneventful and the patient walked the next postoperative day.  Several pre and-postoperative check X-rays were performed.