Traumatic posterior atlantoaxial dislocation with associated C1 Jefferson fracture and bilateral vertebral artery occlusion without odontoid process fracture or neurological deficit.

Abstract

Traumatic atlantoaxial dislocation (AAD) is usually associated with fatal high-velocity road traffic accidents (Xu et al. in Medicine (Baltimore) 94:e1768, 2015). There are few reports of survival following posterior AAD without odontoid fracture (Xu et al. 2015; Zhen et al. in Arch Orthop Trauma Surg 131:681-685, 2011; de Carvalho and Swash in Handb Clin Neurol 119:435-448, 2014). We present a previously undescribed case of posterior AAD associated with a C1 Jefferson fracture but no odontoid fracture and bilateral vertebral artery occlusion without neurological deficit. The presence of bilateral vertebral artery occlusion raised challenges in the surgical management. Survival was only possible due to the presence of robust cerebral collateral circulation.