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synonyms:Jefferson fracture, C1 fracture, Burst fracture, lateral mass fracture, first cervical vertebra fracture
Atlas Fracture ICD-10
- S12.000A Unspecified displaced fracture first cervical vertebra, initial closed
- S12.001A Unspecified nondisplaced fracture first cervical vertebra, initial closed
- S12.01XA Stable burst fracture first cervical vertebra, initial closed
- S12.02XA Unstable burst fracture first cervical vertebra, initial closed
- S12.030A Displaced posterior arch fracture first cervical vertebra, initial closed
- S12.031A Nondisplaced posterior arch fracture first cervical vertebra, initial closed
- S12.040A Displaced lateral mass fracture first cervical vertebra, initial closed
- S12.041A Nondisplaced lateral mass fracture first cervical vertebra, initial closed
- S12.090A Other displaced fracture first cervical vertebra, initial closed
- S12.091A Other nondisplaced fracture first cervical vertebra, initial closed
- See all First Cervical Vertebra ICD-10 codes
Atlas Fracture Etiology / Epidemiology / Natural History
- Typically high energy trauma
Atlas Fracture Anatomy
Atlas Fracture Clinical Evaluation
- Palpate entire spine for tenderness / step off.
- Complete neuro exam: motor strength, pin-prick sensation, reflexes, cranial nerves, rectal examination (perineal pin-prick sensation, sphincter tone, volitional spincter control)
- Absence of the bulbocaverosus reflex indicates spinal shock. Level of spinal injury can not be determined until bulbocaverosus reflex has returned.
- See ASIA form.
- Burst fractures: pain when nodding the head
Atlas Fracture Xray / Diagnositc Tests
- A/P, Lateral, Odontoid views:
- CT cervical spine:
- MRI:
- Burst fractures demonstrate bilateral symmetric overhang of the lateral masses of the atlas in relation ot the axis. Open month view demonstrates increased paradontoid space
Atlas Fracture Classification / Treatment
- Isolated anterior Arch, Posterior Arch, lateral mass fracture
-Treatment = orthosis x 6-12 weeks
- Jefferson burst fracture:
-Stable if combined lateral overhand of the atlas <7mm. Treatment = orthosis or halo x 12 weeks. -Unstable if transverse diameter of the atlas is >7mm greater then that of the axis, transverse ligament rupture should be suspected. Treatment = C1-2 fusion with Magerl screws or Harms technique.
Atlas Fracture Associated Injuries / Differential Diagnosis
- Occipital Condyle Fracture
- Occipitocervical Dissociation
- C2 fracture
- Odontoid fracture
Atlas Fracture Complications
Atlas Fracture Follow-up Care
Atlas Fracture Review References
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