Basilar invagination resulting from untreated Jefferson's fracture

Day, GL; Cg, Jacoby; Kd, Dolan

doi:10.2214/ajr.133.3.529

American Journal of Roentgenology

1979

DOI: 10.2214/ajr.133.3.529

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Basilar invagination resulting from untreated Jefferson's fracture

GL Day¹,

Jacoby Cg²,

Dolan Kd³

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1981

2005

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Cited by 2 publications

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“…One patient had anterior dislocation of the atlas on the axis due to juvenile rheumatoid arthritis. One previously reported patient had an old malunited fracture of the first cervical vertebra [5]. One patient had vitamin D resistant rickets which produced posterior arch hypertrophy in the upper cervical spine resultiqg in posterior spinal cord compression.…”

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confidence: 99%

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Gas and metrizamide myelography in abnormalities of the craniovertebral junction

et al. 1981

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“…Altered bony relationships in such patients make it difficult to determine the proper needle path when a C~-Cz puncture is attempted. Careful injection of air or metrizamide via a lumbar puncture and meticulous positioning should result in adequate demonstration of the upper cervical anatomy [4,5].…”

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Gas and metrizamide myelography in abnormalities of the craniovertebral junction

et al. 1981

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Novel treatment of basilar invagination resulting from an untreated C-1 fracture associated with transverse ligament avulsion

Ames

Acosta²,

Nottmeier³

2005

Journal of Neurosurgery: Spine

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✓ The authors describe the case of a traumatic C-1 ring fracture and transverse ligament injury in an otherwise healthy adult woman; the lesion was essentially untreated for 3 months and resulted in basilar invagination. On presentation 3 months postinjury, the patient complained of severe increasing suboccipital pain and a grinding sensation in her upper neck. Axial computerized tomography (CT) scans revealed a C-1 ring fracture, basilar invagination with the dens abutting the clivus, and significant lateral splaying of the C-1 lateral masses. Flexion—extension radiography demonstrated abnormal motion at the atlantoaxial junction. A unique surgical technique was used to address simultaneously the C1–2 instability, the displaced C-1 fracture, and basilar invagination without having to perform occipital fixation. The authors believe that an understanding of the mechanism of the cranial settling in this case (further splaying of the C-1 lateral masses and downward migration of the occipital condyles) permitted full reduction of the deformity; this was accomplished by performing a horizontal reduction of the C-1 lateral masses, using direct C-1 lateral mass screws, a rod compressor, and a cross-link. Postoperative CT scanning confirmed the success of reduction. The results in this report highlight a rare but important complication of untreated C-1 fracture and ligament disruption, and the authors describe a novel treatment technique with which to restore vertical alignment and preserve occipital C-1 motion. A variation of this technique may also be used to treat Type II transverse ligament injuries associated with C-1 ring fractures as an alternative to halo immobilization.

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Basilar invagination resulting from untreated Jefferson's fracture

Cited by 2 publications

References 2 publications

Gas and metrizamide myelography in abnormalities of the craniovertebral junction

Gas and metrizamide myelography in abnormalities of the craniovertebral junction

Novel treatment of basilar invagination resulting from an untreated C-1 fracture associated with transverse ligament avulsion

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