Reduction and Open Fixation of a Cervical Teardrop Fracture: A Technical Note

Gregory W. Basil, Vignessh Kumar, Steven Vanni

Research output: Contribution to journalArticlepeer-review


Background: Cervical teardrop fractures are hyperflexion and axial loading injuries associated with significant ligamentous disruption. Patients sustaining these types of injury are classically treated with a cervical corpectomy and anterior fusion. However, there are notable disadvantages of this approach, namely, disruption of the patient's true anatomic alignment and a reduction in the number of fixation points available for cervical fusion. Here we present a novel method of open reduction and internal fixation in a neurologically intact patient with cervical teardrop fracture. Case Description: A 34-year-old man presented to Ryder Trauma Center after a helmeted motorcycle accident. The patient was found to be neurologically intact on arrival, and imaging demonstrated a C5 teardrop fracture without bony retropulsion. The patient was taken to the operating room for an open reduction and internal fixation of the fracture using a novel technique. This technique used traditional diskectomies at the C4-5 and C5-6 levels, along with a temporary, unicortical screw into the C5 body to capture the anteriorly displaced fragment. A bicortical screw was then placed into the contralateral side, and now, having fully reduced the fracture, the first (temporary) screw was replaced with a bicortical screw. The patient was neurologically intact postoperatively, with 2-month follow-up computed tomography scan demonstrating stable reduction of the fracture. Conclusions: Here we present a novel technique for open reduction and internal fixation of a cervical teardrop fracture that does not require cervical corpectomy. This technique is particularly useful in patients with an anteriorly displaced fragment and without neurologic deficit or compromise.

Original languageEnglish (US)
Pages (from-to)142-147
Number of pages6
JournalWorld neurosurgery
StatePublished - Jul 2020


  • Bicortical screw
  • Internal fixation
  • Open reduction
  • Teardrop fracture

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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