title: [Atlas burst fracture (Jefferson fracture) requiring surgical treatment after conservative treatment--report of two cases].
abstract: Most cases of atlas burst fracture do not require surgical stabilization, because they can be successfully treated with external immobilization. The authors present two cases of atlas burst fracture in which surgical stabilization was required after external immobilization. The first patient was a 50-year-old male and the second patient was a 34-year-old male. Both presented with neck pain without neurological symptoms after a traffic accident. Neuroradiological examinations revealed atlas burst fracture in both patients. They were initially treated with conservative treatment; one with a rigid collar and the other with a halo vest. However, lateral offset of the atlas on the axis increased and atlanto-axial instability became evident three months later in both patients. They underwent upper cervical arthrodesis with satisfactory results. The authors review surgical indication and its timing in patients with atlas burst fracture.
authors.affiliation: Department of Neurosurgery, Toyama Medical and Pharmaceutical University, 2630 Sugitani, Toyama-city, Toyama 930-0194, Japan.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Masanori
authors.initials: M
authors.lastname: Kurimoto
authors.forename: Nakamasa
authors.initials: N
authors.lastname: Hayashi
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ohmori
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Hirashima
authors.forename: Shunro
authors.initials: S
authors.lastname: Endo
mesh_terms: D000328:Adult; D001270:Cervical Atlas / Q000293:injuries*; D016267:External Fixators; D006801:Humans; D008297:Male; D008875:Middle Aged; D016103:Spinal Fractures / Q000601:surgery*; D013123:Spinal Fusion; D016896:Treatment Outcome