JEFFERSON/ BURST FRACTURE

Question 1

What is a Jefferson/ burst fracture ?

Answer 1

It is a burst fracture of C1. Failure of the bone will be at the anterior or posterior arches and displacement of fracture fragments.

Question 2

What are three features seen on a peg view of a patient with a burst fracture ?

Answer 2

1. Lateral masses displaced laterally.
2. Alignment between C1 and C2 lost.
3. Distance between the dens of C2 and lateral masses of C1 increase. lateral masses fall laterally.

Question 3

How do burst fractures occur ?

Answer 3

Axial loading at the top of the head which then puts pressure of the lateral masses and C1 bursts.

Diving head first into shallow water or spear tackle in rugby.

Question 4

If we have a burst fracture what artery do we need to be concerned about ?

Answer 4

Vertebral arteries.

Question 5

What are the Xray features on an AP view ?

Answer 5

Widening of the body of C1.

Question 6

What are the Xray features on a lateral view ?

Answer 6

Widening of the body of C1.

Reduction in the occiput/C1 distance and the C1/C2 interspinous distance.

Spino lamina line disrupted.
May have an associated C2 fracture.