title: Posterior reduction and fixation of an unstable Jefferson fracture with C1 lateral mass screws, C2 isthmus screws, and crosslink fixation: technical case report.
abstract: OBJECTIVE
  We sought to describe a modified technique for the reduction and stabilization of unstable Jefferson fractures.
  
  
  METHODS
  We present the case of an isolated unstable Jefferson fracture in a 33-year-old woman. The patient was the victim of a motor vehicle accident. Her neurological examination was normal. A cervical computed tomographic scan revealed an isolated Jefferson fracture that we thought to be unstable when we applied the Spence criteria.
  
  
  METHODS
  The fracture was treated by a technical variant of C1-C2 posterior fixation with compression on the rods by means of a crosslink connector, allowing the reduction of the atlantoaxial lateral mass overhanging. C1-C2 fusion with posterior iliac crest bone graft was added.
  
  
  CONCLUSIONS
  The 1-year radiological follow-up evaluation showed a complete consolidation of the fracture lines and atlantoaxial stability. This technique could be an option for the reduction and stabilization of the unstable Jefferson fractures.
authors: Neurosurgical Unit, Geneva University Hospital, Geneva, Switzerland. tessenri@libero.it
authors: Enrico
authors: E
authors: Tessitore
authors: Armen
authors: A
authors: Momjian
authors: Michael
authors: M
authors: Payer
mesh_terms: D000328:Adult; D001863:Bone Screws; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D011859:Radiography; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000601:surgery*