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The 24 year-old female patient was in a traffic accident which caused a dislocated Jefferson fracture and a dens-fracture type II after Anderson.
How to injuries like that happen:
Axial forces to the cervival spine are transferred to the upper head/skull joint by the occipital condiles. In this area there is no intervertebral disc and therefore the atlas has to distribute the incoming forces without a buffer. The axial forces are transferred to the sides by the inclinations of the joint surface areas. These sideways forces can cause the atlas archs to burst. The archs then go sideways and this can cause a rupture of the transverse ligaments. This ligament guarantees stability of the lower head/skull joint which is between atlas and axis. A rupture leads to istability of the joint and pressure on the spinal cord is possible.
Therapy: Stable, non-dislocated fractures of the atlas can often be treated conservatively with a cervical collar (neck brace) which is worn for 8-10 weeks.
Jefferson fractures with ligament rupture and dislocation of C1 against C2 have to be treated surgically. Possible operations are:
