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C1-Ring Osteosynthesis for Unstable, Jefferson Burst Fractures

  • Jason L. Pittman
  • Richard J. Bransford
Chapter

Abstract

C1 osteosynthesis is a valuable and powerful technique that allows the treating surgeon to preserve motion between occiput, C1, and C2 in patients with unstable Jefferson fractures. Careful evaluation of the preoperative CT scan and consideration of the patient’s individual fracture pattern and anatomy are critical to the success of this technique. Placement of 3.5-mm screws into the lateral masses of C1 allows compression of the fracture and posterior stabilization for reduction of unstable fractures with minimal impact on cervical range of motion.

Bibliography

  1. 1.
    Koller H, Resch H, Tauber M, Zenner J, Augat P, Penzkofer R, Acosta F, Kolb K, Kathrein A, Hizl W. A biomechanical rationale for C1-ring osteosynthesis as treatment for displaced Jefferson burst fractures with incompetency of the transverse atlantal ligament. Eur Spine J. 2010;19(8):1288–98.CrossRefGoogle Scholar
  2. 2.
    Bransford RJ, Freeborn MA, Russo AJ, Nguyen QT, Lee MJ, Chapman JR, Bellabarba C. Accuracy & complications associated with posterior C1 screw fixation techniques: a radiographic and clinical assessment. Spine J. 2012;12(3):231–8.CrossRefGoogle Scholar
  3. 3.
    Jo KW, Park IS, Hong JT. Motion-preserving reduction and fixation of C1 Jefferson fracture using a C1 lateral mass screw construct. J Clin Neurosci. 2011;18(5):695–8.CrossRefGoogle Scholar
  4. 4.
    Shatsky J, Bellabarba C, Nguyen QT, Bransford RJ. The transverse atlantal ligament (TAL) does not matter—a retrospective review of fixation of C1 ring fractures. Spine J. 2016;16(3):372–9.CrossRefGoogle Scholar
  5. 5.
    Dvorak MF, Johnson MG, Boyd M, Johnson G, Kwon BK, Fisher CG. Long-term health-related quality of life outcomes following Jefferson-type burst fractures of the atlas. J Neurosurg Spine. 2005;2:411–7.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Jason L. Pittman
    • 1
  • Richard J. Bransford
    • 2
  1. 1.Department of Orthopaedic SurgeryUniversity of Alabama at BirminghamBirminghamUSA
  2. 2.Department of Orthopaedic and Neurological SurgeryHarborview Medical CenterSeattleUSA

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