title: Avulsion fracture of the foramen magnum treated with occiput-to-c1 fusion: technical case report.
abstract: OBJECTIVE
  A 31-year-old woman presented with an avulsion fracture of the foramen magnum via bilateral occipital condyles with extension through the inferior aspect of the clivus.
  
  
  METHODS
  The patient had no neurological deficits and was initially immobilized in a halo brace.
  
  
  METHODS
  To preserve rotational motion at C1-C2, we performed an occiput-to-C1 fusion with bilateral C1 lateral mass screws attached with rods to occipital keel screws. Postoperatively, the patient remained neurologically intact. Three-month follow-up imaging revealed no abnormal motion. Follow-up computed tomographic scan showed an intact construct and bony fusion.
  
  
  CONCLUSIONS
  This rare injury, a bony variant of occipitoatlantal dislocation, was successfully treated with a unique occiput-to-C1 fusion.
authors.affiliation: Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Maughan
authors.forename: Eric M
authors.initials: EM
authors.lastname: Horn
authors.forename: Nicholas
authors.initials: N
authors.lastname: Theodore
authors.forename: Iman
authors.initials: I
authors.lastname: Feiz-Erfan
authors.forename: Volker K H
authors.initials: VK
authors.lastname: Sonntag
mesh_terms: D000328:Adult; D001268:Atlanto-Axial Joint / Q000473:pathology; D001269:Atlanto-Occipital Joint / Q000473:pathology; D005260:Female; D005539:Foramen Magnum / Q000473:pathology*; D005592:Fracture Fixation / Q000379:methods*; D050723:Fractures, Bone / Q000628:therapy*; D006801:Humans; D008279:Magnetic Resonance Imaging; D016896:Treatment Outcome