Surgically Treated Fracture of the C7 Vertebra with Hangman’s Fracture Morphology in a 59-Year-Old Patient – Case Report

Abstract

Introduction. Hangman’s fractures are a rare type of cervical spine injury, usually involving the C2 vertebra. However, in exceptional cases, they can affect other cervical vertebrae, including C7.

Aim. In this paper, we present a case of an atypical fracture of the C7 vertebra with hangman’s fracture morphology and describe its surgical treatment.

Case Report. We present the case of a 59-year-old male with a fracture of the C7 vertebra with a morphology resembling that of a hangman’s fracture, which typically occurs at the C2 vertebra. Hangman’s fractures most often result from hyperextension injuries, whereas, in this case, the fracture occurred due to a fall. The fracture was successfully treated surgically. Stabilisation of C6-C7-Th1 was performed via an anterior approach.

Discussion. The instability mechanism in the fracture described in this case involves the separation of the C7 vertebral body from the rest of the vertebra and its apparent subluxation relative to Th1. Thus, the only surgical treatment that ensures the stabilisation of such a fracture is the fusion of C6-C7-Th1, so that the fractured vertebra is fused to both the vertebra above and below.

Conclusions. Although C7 fractures can resemble hangman’s fractures in terms of injury mechanism, there are significant anatomical and biomechanical differences. The stabilisation must involve the fractured vertebra and fuse it with the vertebra above and below. (JNNN 2025;14(1):43–46)