Posterior Reduction and Fixation of an Unstable Jefferson Fracture with C1 Lateral Mass Screws, C2 Isthmus Screws, and Crosslink Fixation: Technical Case Report

Abstract

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.