Kumar Aravind, Onggo James, Fon Lim Hai, Oh Jacob
Ng Teng Fong Hospital, Department of Orthopaedics, Singapore.
Monash University, Monash Medical School, Melbourne, Australia.
Int J Spine Surg. 2019 Aug 31;13(4):345-349. doi: 10.14444/6047. eCollection 2019 Aug.
Jefferson fractures are classically described as burst fractures of C1. Traditional surgical treatment of these unstable fractures is either occipito-cervical or posterior C1-C2 fusion, resulting in a significant loss of range of cervical neck movement. This case report discusses the fixation of a Jefferson fracture using C1 lateral mass screws to achieve surgical stabilization while preserving the range of movement. We aim to add to the body of evidence supporting this fixation method.
A 39-year-old male presented to our emergency department with an unstable Jefferson fracture caused by trauma. The various treatment options, such as cervical collar, HALO immobilization, occipito-cervical fusion, and atlanto-axial fusion and direct fixation of C1, were evaluated and discussed with the patient. Informed consent was obtained from the patient prior to writing this case report.
At 3 months postoperation, the patient demonstrated near full range of movement in his neck. He had also resumed driving. By 6 months, the patient returned to work, and at 12 months, imaging confirmed union.
This case report adds to the body of evidence supporting the technique of C1 lateral mass screws for direct stable fixation of Jefferson fractures. This fixation method preserves the cervical spine range of motion with minimal functional restriction.
Jefferson骨折通常被描述为C1爆裂骨折。这些不稳定骨折的传统手术治疗方法是枕颈融合或C1-C2后路融合，会导致颈椎活动范围显著丧失。本病例报告讨论了使用C1侧块螺钉固定Jefferson骨折以实现手术稳定，同时保留活动范围。我们旨在补充支持这种固定方法的证据。
一名39岁男性因外伤导致不稳定的Jefferson骨折就诊于我院急诊科。评估了各种治疗方案，如颈托、头环固定、枕颈融合、寰枢椎融合以及C1直接固定，并与患者进行了讨论。在撰写本病例报告之前，已获得患者的知情同意。
术后3个月，患者颈部活动范围几乎完全恢复。他也已恢复驾驶。到6个月时，患者重返工作岗位，12个月时影像学检查证实骨折愈合。
本病例报告补充了支持使用C1侧块螺钉技术直接稳定固定Jefferson骨折的证据。这种固定方法能以最小的功能限制保留颈椎活动范围。
