Jefferson fracture in ankylosing spondylitis

Case contributed by Dr. Chris O'Donnell

Presentation

Heavily intoxicated, fall, now stiff neck. Moving all limbs

Patient Data

Age: 70
Gender: Male

Typical pattern of a Jefferson fracture including the anterior and posterior arches but no lateral displacement of the lateral masses as is usual due to an axial load injury ie through the head.  

Case Discussion

In this case the dens is displaced anteriorly in relation to the tip of the clivus possibly due to the grossly fused remainder of the cervical spine (due to ankylosing spondylitis ) ie this is a flexion/extension injury rather than axial.

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