• Eur Spine J · Jun 2019

    Traumatic posterior atlantoaxial dislocation with associated C1 Jefferson fracture and bilateral vertebral artery occlusion without odontoid process fracture or neurological deficit.

    • Mark Nowell and Richard Nelson.
    • Department of Neurosurgery, Southmead Hospital, Bristol, UK. mnowell@gmail.com.
    • Eur Spine J. 2019 Jun 1; 28 (Suppl 2): 9-12.

    PurposeTraumatic atlantoaxial dislocation (AAD) is usually associated with fatal high-velocity road traffic accidents (Xu et al. in Medicine (Baltimore) 94:e1768, 2015). There are few reports of survival following posterior AAD without odontoid fracture (Xu et al. 2015; Zhen et al. in Arch Orthop Trauma Surg 131:681-685, 2011; de Carvalho and Swash in Handb Clin Neurol 119:435-448, 2014).MethodWe present a previously undescribed case of posterior AAD associated with a C1 Jefferson fracture but no odontoid fracture and bilateral vertebral artery occlusion without neurological deficit.ConclusionThe presence of bilateral vertebral artery occlusion raised challenges in the surgical management. Survival was only possible due to the presence of robust cerebral collateral circulation.

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