Skip Navigation LinksHome > July 2008 - Volume 63 - Issue 1 > POSTERIOR REDUCTION AND FIXATION OF AN UNSTABLE JEFFERSON FR...
Neurosurgery:
doi: 10.1227/01.NEU.0000312343.88550.C3
SPINE: Technical Case Report

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.

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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.

Copyright © by the Congress of Neurological Surgeons

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