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POSTERIOR REDUCTION AND FIXATION OF AN UNSTABLE JEFFERSON FRACTURE WITH C1 LATERAL MASS SCREWS, C2 ISTHMUS SCREWS, AND CROSSLINK FIXATION: TECHNICAL CASE REPORT

Tessitore, Enrico M.D.; Payer, Michael M.D.; Momjian, Armen M.D.

doi: 10.1227/01.NEU.0000312343.88550.C3
SPINE: Technical Case Report

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.

Neurosurgical Unit, Geneva University Hospital, Geneva, Switzerland (Tessitore) (Payer)

Maxillo-facial Surgery Unit, Geneva University Hospital, Geneva, Switzerland (Momjian)

Reprint requests: Enrico Tessitore, M.D., Neurosurgical Unit, University Hospital of Geneva, Rue Micheli du Crest 24, 1205 Geneva, Switzerland. Email: tessenri@libero.it

Received, September 6, 2007.

Accepted, February 8, 2008.

Copyright © by the Congress of Neurological Surgeons