Presentation
Patient presented following motor vehicle collision as the unrestrained passenger.
Patient Data
CT cervical spine in axial, coronal, and sagittal planes. The axial view shows all three fractures of the bilateral anterior arch and right posterior arch of C1. Coronal view demonstrates only the right posterior arch fracture of C1. The right posterior and right anterior arch fractures of C1 are re-demonstrated in sagittal view.
Case Discussion
Jefferson fracture is defined as a burst fracture of the C1 vertebra, typically resulting from axial loading, such as diving headfirst into shallow water or in motor vehicle collisions 1. This case presents a Jefferson fracture with bilateral anterior arch fractures and a right posterior arch fracture, without transverse atlantal ligament injury.
When evaluating Jefferson fractures, it is important to consider other potential injuries, such as a C1 fracture without burst characteristics which may only include isolated anterior or posterior arch fractures. Other commonly associated injuries include odontoid or C2 fractures 2.
Cervical spine precautions were advised in this case, and no neurosurgical intervention was required due to the stability of the fracture. The absence of transverse ligament injury suggests a favourable prognosis.
Additional authors:
Al Khadim N, Rana G, Apushkin M.
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