CC BY 4.0 · Indian Journal of Neurotrauma 2023; 20(02): 140-147
DOI: 10.1055/s-0042-1759854
Original Article

Technical Considerations in Surgical Fixation of Jefferson Fracture

Hitesh Kumar Gurjar
1   Department of Neurosurgery & Gamma-Knife, All India Institute of Medical Sciences, New Delhi, India
Hitesh Inder Singh Rai
1   Department of Neurosurgery & Gamma-Knife, All India Institute of Medical Sciences, New Delhi, India
Shashwat Mishra
1   Department of Neurosurgery & Gamma-Knife, All India Institute of Medical Sciences, New Delhi, India
Kanwaljeet Garg
1   Department of Neurosurgery & Gamma-Knife, All India Institute of Medical Sciences, New Delhi, India
› Author Affiliations
Source/Disclosure of Funding None.


Jefferson fracture is defined as the simultaneous disruption of the continuity of the anterior and posterior arches of the atlas vertebra. It generally results from an axial impact to the head. Most of these fractures are amenable to nonoperative management. Significant disruption of the transverse atlantal ligament that is the main stabilizing ligament of the atlantoaxial articulation and contiguous spinal injuries often form the indications for operative intervention in these fractures. The outward and caudal displacement of the C1 lateral masses observed in these fractures often requires significant deviation from the standard operative technique of atlantoaxial fixation when the osseous elements are intact. Accordingly, we have described the surgical nuances relevant to the exposure and instrumentation of the atlantoaxial region in the setting of Jefferson fracture, through our experience in two cases.

Publication History

Article published online:
27 December 2022

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