C1 isolated posterior arch fracture

Background

Stable cervical spine fracture
- Anterior arch and transverse ligament are unaffected
Also called a Landells Atlas Type I fracture
Rule out burst fracture

Vertebral fractures and dislocations types

Vertebral anatomy.

Clinical Features

Due to forced neck extension

Differential Diagnosis

Neck Trauma

Diagnosis

Vertical fracture line through posterior arch seen on lateral x-ray
CT test of choice to evaluate for associated fractures
MRI can evaluate ligamentous injury (transverse ligament is primary AA junction stabilizer)

Management

Hard collar for 6-12 weeks
- Neurosurgery may prefer Halo immobilization
Prehospital Immobilization see NAEMSP National Guidelines for Spinal Immobilization

Disposition

Usually discharge (if truly isolated) in consultation with neurosurgery

See Also

Cervical spine injuries
C-Spine X-Ray
C1 isolated anterior arch fracture
Jefferson fracture

References

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