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Jefferson C1 Fracture
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Atlas burst fracture
              • Definitions

                • Fracture(s) of C1 ring

              IMAGING

              • General Features

                • Radiographic Findings

                  • Fluoroscopic Findings

                    • CT Findings

                      • MR Findings

                        • Angiographic Findings

                          • Imaging Recommendations

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                • Staging, Grading, & Classification

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Ryken TC et al: Management of isolated fractures of the atlas in adults. Neurosurgery. 72 Suppl 2:127-31, 2013
                                              2. Munera F et al: Imaging Evaluation of Adult Spinal Injuries: Emphasis on Multidetector CT in Cervical Spine Trauma. Radiology. 263(3):645-60, 2012
                                              3. Kakarla UK et al: Atlas fractures. Neurosurgery. 66(3 Suppl):60-7, 2010
                                              4. Chen YF et al: Imaging of craniovertebral junction. Neuroimaging Clin N Am. 19(3):483-510, 2009
                                              5. Klimo P Jr et al: Cervical spine trauma in the pediatric patient. Neurosurg Clin N Am. 18(4):599-620, 2007
                                              6. Korinth MC et al: Jefferson fracture in a child--illustrative case report. Pediatr Neurosurg. 43(6):526-30, 2007
                                              7. Lustrin ES et al: Pediatric cervical spine: normal anatomy, variants, and trauma. Radiographics. 23(3): 539-60, 2003
                                              8. Torreggiani WC et al: Musculoskeletal case 20. Jefferson fracture (C1 burst fracture). Can J Surg. 45(1):16, 65-6, 2002
                                              9. Connor SE et al: Congenital midline cleft of the posterior arch of atlas: a rare cause of symptomatic cervical canal stenosis. Eur Radiol. 11(9):1766-9, 2001
                                              10. Harris J Jr: The cervicocranium: its radiographic assessment. Radiology. 218(2):337-51, 2001
                                              11. Judd DB et al: Pediatric atlas fracture: a case of fracture through a synchondrosis and review of the literature. Neurosurgery. 46(4):991-4; discussion 994-5, 2000
                                              12. Sharma A et al: Partial aplasia of the posterior arch of the atlas with an isolated posterior arch remnant: findings in three cases. AJNR Am J Neuroradiol. 21(6): 1167-71, 2000
                                              13. Guiot B et al: Complex atlantoaxial fractures. J Neurosurg. 91(2 Suppl): 139-43, 1999
                                              14. Haakonsen M et al: Midline anterior and posterior atlas clefts may simulate a Jefferson fracture. A report of 2 cases. Acta Orthop Scand. 66(4):369-71, 1995
                                              15. Currarino G et al: Congenital defects of the posterior arch of the atlas: a report of seven cases including an affected mother and son. AJNR Am J Neuroradiol. 15(2):249-54, 1994
                                              16. Kesterson L et al: Evaluation and treatment of atlas burst fractures (Jefferson fractures). J Neurosurg. 75(2):213-20, 1991
                                              17. Lee C et al: Unstable Jefferson variant atlas fractures: an unrecognized cervical injury. AJNR Am J Neuroradiol. 12(6):1105-10, 1991
                                              18. Gehweiler JA Jr et al: Malformations of the atlas vertebra simulating the Jefferson fracture. AJR Am J Roentgenol. 140(6):1083-6, 1983
                                              19. Suss RA et al: Pseudospread of the atlas: false sign of Jefferson fracture in young children. AJR Am J Roentgenol. 140(6):1079-82, 1983
                                              20. Jefferson G: Fracture of the atlas vertebra. Report of four cases, and a review of those previously recorded. Br J Surg. 7(27):407-22, 1919
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Synonyms

                                                            • Atlas burst fracture
                                                          • Definitions

                                                            • Fracture(s) of C1 ring

                                                          IMAGING

                                                          • General Features

                                                            • Radiographic Findings

                                                              • Fluoroscopic Findings

                                                                • CT Findings

                                                                  • MR Findings

                                                                    • Angiographic Findings

                                                                      • Imaging Recommendations

                                                                        DIFFERENTIAL DIAGNOSIS

                                                                          PATHOLOGY

                                                                          • General Features

                                                                            • Staging, Grading, & Classification

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      DIAGNOSTIC CHECKLIST

                                                                                      • Consider

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Ryken TC et al: Management of isolated fractures of the atlas in adults. Neurosurgery. 72 Suppl 2:127-31, 2013
                                                                                          2. Munera F et al: Imaging Evaluation of Adult Spinal Injuries: Emphasis on Multidetector CT in Cervical Spine Trauma. Radiology. 263(3):645-60, 2012
                                                                                          3. Kakarla UK et al: Atlas fractures. Neurosurgery. 66(3 Suppl):60-7, 2010
                                                                                          4. Chen YF et al: Imaging of craniovertebral junction. Neuroimaging Clin N Am. 19(3):483-510, 2009
                                                                                          5. Klimo P Jr et al: Cervical spine trauma in the pediatric patient. Neurosurg Clin N Am. 18(4):599-620, 2007
                                                                                          6. Korinth MC et al: Jefferson fracture in a child--illustrative case report. Pediatr Neurosurg. 43(6):526-30, 2007
                                                                                          7. Lustrin ES et al: Pediatric cervical spine: normal anatomy, variants, and trauma. Radiographics. 23(3): 539-60, 2003
                                                                                          8. Torreggiani WC et al: Musculoskeletal case 20. Jefferson fracture (C1 burst fracture). Can J Surg. 45(1):16, 65-6, 2002
                                                                                          9. Connor SE et al: Congenital midline cleft of the posterior arch of atlas: a rare cause of symptomatic cervical canal stenosis. Eur Radiol. 11(9):1766-9, 2001
                                                                                          10. Harris J Jr: The cervicocranium: its radiographic assessment. Radiology. 218(2):337-51, 2001
                                                                                          11. Judd DB et al: Pediatric atlas fracture: a case of fracture through a synchondrosis and review of the literature. Neurosurgery. 46(4):991-4; discussion 994-5, 2000
                                                                                          12. Sharma A et al: Partial aplasia of the posterior arch of the atlas with an isolated posterior arch remnant: findings in three cases. AJNR Am J Neuroradiol. 21(6): 1167-71, 2000
                                                                                          13. Guiot B et al: Complex atlantoaxial fractures. J Neurosurg. 91(2 Suppl): 139-43, 1999
                                                                                          14. Haakonsen M et al: Midline anterior and posterior atlas clefts may simulate a Jefferson fracture. A report of 2 cases. Acta Orthop Scand. 66(4):369-71, 1995
                                                                                          15. Currarino G et al: Congenital defects of the posterior arch of the atlas: a report of seven cases including an affected mother and son. AJNR Am J Neuroradiol. 15(2):249-54, 1994
                                                                                          16. Kesterson L et al: Evaluation and treatment of atlas burst fractures (Jefferson fractures). J Neurosurg. 75(2):213-20, 1991
                                                                                          17. Lee C et al: Unstable Jefferson variant atlas fractures: an unrecognized cervical injury. AJNR Am J Neuroradiol. 12(6):1105-10, 1991
                                                                                          18. Gehweiler JA Jr et al: Malformations of the atlas vertebra simulating the Jefferson fracture. AJR Am J Roentgenol. 140(6):1083-6, 1983
                                                                                          19. Suss RA et al: Pseudospread of the atlas: false sign of Jefferson fracture in young children. AJR Am J Roentgenol. 140(6):1079-82, 1983
                                                                                          20. Jefferson G: Fracture of the atlas vertebra. Report of four cases, and a review of those previously recorded. Br J Surg. 7(27):407-22, 1919