Background: Atypical Hangman's fractures may involve bilateral C2 pedicle fractures. Surgical fixation is often required to prevent instability and neurological impairment. The Judet technique, involving transpedicular screw fixation, offers a targeted approach to stabilize C2 pedicle fractures while preserving cervical motion.

Method: This article presents a neuronavigation-guided modification of the Judet technique for C2 pedicle screw placement. Advanced intraoperative computed tomography (CT) imaging, virtual trajectory planning and intraoperative navigation guidance provide surgical precision and patient safety.

Conclusion: Neuronavigation can improve the classical Judet technique, enhancing clinical safety and accuracy in fixation of C2 pedicle fractures. This minimally invasive/mini-open approach preserves C1-C2 mobility and reduces complications.

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http://dx.doi.org/10.1007/s00701-025-06476-wDOI Listing

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