C1 fracture: Analysis of consolidation and complications rates in a prospective multicenter series

Lleu, Maxime; Charles, Yann Philippe; Blondel, Benjamin; Barresi, Laurent; Nicot, Benjamin; Challier, Vincent; Godard, J.; Kouyoumdjïan, Pascal; Lonjon, Nicolas; Marinho, Paulo Vinícius Tertuliano; Freitas, Eurico; Schuller, S.; Fuentès, S.; Allia, Jérémy; Berthiller, Julien; Barrey, Cédric

doi:10.1016/j.otsr.2018.06.014

Cited by 16 publications

(23 citation statements)

References 24 publications

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“…Symptoms of neurological dysfunction are rare in patients with atlas fracture because fractures of the atlas ring increase the space that is available for the dural sac, thereby inhibiting compression [ 13 ]. So that, stabilization of fractures is the most important factor for the treatment of atlas fractures.…”

Section: Discussionmentioning

confidence: 99%

“…But, it is now believed that combined fractures of the anterior and posterior atlantal arches are the unstable fractures, whether or not they are associated with rupture of the TAL [3,4,8]. Symptoms of neurological dysfunction are rare in patients with atlas fracture because fractures of the atlas ring increase the space that is available for the dural sac, thereby inhibiting compression [13]. So that, stabilization of fractures is the most important factor for the treatment of atlas fractures.…”

Section: Discussionmentioning

confidence: 99%

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Motion-preserving treatment of unstable atlas fracture: transoral anterior C1-ring osteosynthesis using a laminoplasty plate

Zou

Ouyang

Wang

et al. 2020

BMC Musculoskelet Disord

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Background C1-ring osteosynthesis is a valid alternative to posterior C1–C2 or C0–C2 fusion to preserve important C1–C2 motion in the treatment of unstable atlas fractures. Nevertheless, the fixation instruments used in current studies for transoral anterior C1-ring osteosynthesis were not suitable for anterior anatomy of the atlas or did not have reduction mechanism. We therefore present this report to investigate preliminary clinical effects of transoral anterior C1-ring osteosynthesis using a laminoplasty plate in unstable atlas fractures. Methods From January 2014 to December 2017, 13 patients with unstable atlas fractures were retrospectively reviewed. All patients were treated with transoral anterior C1-ring osteosynthesis using a laminoplasty plate. Pre- and postoperative images were obtained to assess reduction of the fracture, internal fixation placement, and bone union. Neurological function, range of motion, and pain levels were evaluated clinically on follow-up. Results The surgeries were successfully performed in all cases. The average follow-up duration was 16.6 ± 4.4 months (range 12–24 months). One patient suffered screw loosening after operation and underwent replacement operation subsequently. Satisfactory clinical outcomes were achieved in all patients with ideal fracture reduction, reliable plate placement, well-preserved range of motion, and neck pain alleviation. All patients achieved bone union of fractures without loss of reduction or implant failure or C1–C2 instability during the follow-up. No vascular or neurological complication was noted during the operation and follow-up. Conclusions Transoral anterior C1-ring osteosynthesis using a laminoplasty plate is a effective surgical treatment for unstable atlas fractures. This technique has a ingenious reduction mechanism, and can provide satisfactory bone union and preservation of C1–C2 motion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Motion-preserving treatment of unstable atlas fracture: transoral anterior C1-ring osteosynthesis using a laminoplasty plate

Zou

Ouyang

Wang

et al. 2020

BMC Musculoskelet Disord

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“…It is cited to have a 33.3% prevalence of nonunion across both operative and nonoperative management. 7 Other atlas fracture types and their associated nonunion prevalence are detailed in 8 However, the patient rejected it because of the perceived practical difficulties and inconvenience of managing it for a period of potentially up to 3 months. The 1week delay in presentation was also taken into consideration as a risk factor for nonunion with conservative measures, thus further justifying the use of direct operative fixation.…”

Section: Discussionmentioning

confidence: 99%

Direct Fixation of C1 Jefferson Fracture Using C1 Lateral Mass Screws: A Case Report

et al. 2019

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Background: Jefferson fractures are classically described as burst fractures of C1. Traditional surgical treatment of these unstable fractures is either occipito-cervical or posterior C1-C2 fusion, resulting in a significant loss of range of cervical neck movement. This case report discusses the fixation of a Jefferson fracture using C1 lateral mass screws to achieve surgical stabilization while preserving the range of movement. We aim to add to the body of evidence supporting this fixation method. Methods: A 39-year-old male presented to our emergency department with an unstable Jefferson fracture caused by trauma. The various treatment options, such as cervical collar, HALO immobilization, occipito-cervical fusion, and atlanto-axial fusion and direct fixation of C1, were evaluated and discussed with the patient. Informed consent was obtained from the patient prior to writing this case report. Results: At 3 months postoperation, the patient demonstrated near full range of movement in his neck. He had also resumed driving. By 6 months, the patient returned to work, and at 12 months, imaging confirmed union. Conclusions: This case report adds to the body of evidence supporting the technique of C1 lateral mass screws for direct stable fixation of Jefferson fractures. This fixation method preserves the cervical spine range of motion with minimal functional restriction.

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“…Both the cases presented here are unstable type II atlas fracture involving both anterior and posterior arches. Such fractures are observed to be prone to non-union (33.3%) across both operative and non-operative management [9]. Unstable Jefferson fractures are normally treated with fusion.…”

Section: Case-2mentioning

confidence: 99%

Fracture of C1 vertebra managed with unilateraltrans articular screw fixation- Report of two cases

2020

OJOT

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Fracture of C1 vertebra managed with unilateral trans-articular screw fixation-Report of two casesFracture of C1 vertebrae nearly accounts for 2-13% of cervical spine injury. The fracture may be stable or unstable. If both anterior and posterior arch of atlas is fractured then it is considered an unstable type and needs surgical intervention. Various fixation methods have been described by researchers. We describe two cases of unstable C1 fractures managed with trans-articular screw fixation by minimal invasive technique. Trans-articular screw fixation is a less invasive and safe method for unstable C1 fractures.

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C1 fracture: Analysis of consolidation and complications rates in a prospective multicenter series

Cited by 16 publications

References 24 publications

Motion-preserving treatment of unstable atlas fracture: transoral anterior C1-ring osteosynthesis using a laminoplasty plate

Motion-preserving treatment of unstable atlas fracture: transoral anterior C1-ring osteosynthesis using a laminoplasty plate

Direct Fixation of C1 Jefferson Fracture Using C1 Lateral Mass Screws: A Case Report

Fracture of C1 vertebra managed with unilateraltrans articular screw fixation- Report of two cases

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