Posterior reduction and fixation of an unstable Jefferson fracture with C1 lateral mass screws, C2 isthmus screws, and crosslink fixation: technical case report

Neurosurgery. 2008 Jul;63(1 Suppl 1):ONSE100-1; discussion ONSE101. doi: 10.1227/01.neu.0000335022.91240.c9.

Abstract

Objective: We sought to describe a modified technique for the reduction and stabilization of unstable Jefferson fractures.

Clinical presentation: We present the case of an isolated unstable Jefferson fracture in a 33-year-old woman. The patient was the victim of a motor vehicle accident. Her neurological examination was normal. A cervical computed tomographic scan revealed an isolated Jefferson fracture that we thought to be unstable when we applied the Spence criteria.

Technique: The fracture was treated by a technical variant of C1-C2 posterior fixation with compression on the rods by means of a crosslink connector, allowing the reduction of the atlantoaxial lateral mass overhanging. C1-C2 fusion with posterior iliac crest bone graft was added.

Conclusion: The 1-year radiological follow-up evaluation showed a complete consolidation of the fracture lines and atlantoaxial stability. This technique could be an option for the reduction and stabilization of the unstable Jefferson fractures.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Bone Screws*
  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / surgery*
  • Female
  • Fracture Fixation, Internal / instrumentation*
  • Fracture Fixation, Internal / methods*
  • Humans
  • Radiography
  • Spinal Fractures / diagnostic imaging
  • Spinal Fractures / surgery*