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

Abstract

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