The Jefferson fracture is a complex burst
fracture of the ring of the atlas (C1) (see figure below). This fracture
pattern was first described by Geofrey Jefferson. Classically, it involves fractures of the anterior and posterior arches of C1 on both
the right and left sides (4 fractures). But fracture variants may include two or
three-part fractures. Nearly 1/3 of Jefferson fractures are associated with a fracture of C2.
are other types of Atlas fractures, than that of the Jefferson
fracture. To review them, and also get more information about the
Jefferson fracture, visit: Atlas fracture.
There is usually no cord compression and associated neurologic deficit, because the fracture widens the ring of C1. There is
usually lateral spread of the lateral masses of C1 vertebra on C2 at open-mouth cervical x-ray (see figure below).
Open-mouth cervical x-ray
showing bilateral, lateral offset of C1 on C2
The jefferson fracture typically caused by an axial loading on the
head. The trauma most frequently occurs during diving into shallow
water, vehicle accidents, and falling onto the head from a height.
Imaging Open-mouth (odontoid) view: Classically there is bilateral, lateral offset of C1 on C2. Lateral
view: May show prevertebral soft tissue swelling anterior to C1,
pre-dentate space (distance between the anterior tubercle of C1 and the
dens) may be widened to greater than 3 mm if there is damage to the
transverse ligament. CT Scan: Reveals the fractures, their locations and degree of displacement of fragments.
(collar for 2-3 months) or surgical (occipitocervical fusion)
treatments are available. The treatment selection depends largely on
the degree of offset of C1 on C2 and whether there is damage to the
Jefferson G. Fracture of atlas vertebrae: report of four cases and a
review of those previously recorded. Br J Surg 1920; 7:407–422.
Any comment about this page?
Your feedback is appreciated. Please click
Follow & Share Scientific Spine
To join Scientific Spine mailing list,