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r early post-operative outcomes. In developing countries and centers with suboptimal pediatric intensive care units, surgical intervention is preferred after the first month of life with good temperature control, adequate fluid replacement following rupture of the sac, blood transfusion availability and, only if necessary, complex cranial reconstruction. OBJECTIVE To assess and compare clinical outcomes and sagittal balance following unstable hangman's fracture between anterior C2-C3 discectomy and fusion (ACDF) and posterior C2-C3 shor