$jefferson fracture types$ $jefferson fracture types$

Treating complex CVJ-fractures with coronary artery disease (CAD) requiring treatment is challenging and carries a high risk of complications. Therefore, upper cervical spine trauma can occur together with MI ( 16). In addition, acute MI can lead to syncope, consciousness disturbance and cerebral dysfunction following hemodynamic collapse ( 15). The last is observed especially in women, the elderly and patients with diabetes mellitus or chronic renal insufficiency ( 13, 14). Myocardial infarction (MI) often manifests itself atypically e.g., dyspnea, cardiac arrhythmias, abdominal pain and autonomic dysregulation. One of the most common reasons for emergency department admission remains chest pain caused by acute coronary syndrome. Hence, immediate neuroradiological diagnostic is crucial, dictating patient management. Related lesions are traumatic brain injury, additional fractures of the spine, the midface, the extremities ( 2, 9) and vertebral artery injury ( 10– 12). Identification of craniovertebral junction (CVJ) injury is difficult as patients often present with reduced level of consciousness. Typical causes of accidents are high-velocity impact in polytraumatized patients and increasingly low-energy trauma e.g., domestic collapses in the elderly due to hyperextension on head impact ( 7, 8). Between 19%–51% of spinal trauma cases involve injuries to the cervical spine ( 2), and approximately 30% affecting the atlantoaxial region, with the odontoid being the most common site of injury to the C2 vertebra ( 3– 6). Injuries to the cervical spine occur in 2%–4% of all patients on admission to the emergency room, but may be life-threatening if associated with spinal cord injury (SCI) ( 1).

$jefferson fracture types$

Interdisciplinary cooperation to determine optimal therapeutic algorithms is needed. To receive upper cervical spine stability and to prevent both, spinal cord injury and cardiovascular complications, an individual approach is required. To our knowledge, the literature does not provide any guidelines regarding therapy of this constellation. The patient did not develop neurological deficits and recovered completely from both surgeries.Ĭonclusions: Treating complex C1/C2 fractures with concomitant severe CAD requiring treatment is challenging and carries a high risk of complications. Follow-up CT scan of cervical spine revealed intraosseous screw positioning and beginning fusion of the fractures. One month later bypass surgery was performed uneventfully. Finally, in first step, C1-C2 fusion was performed by Harms technique under general anesthesia with x-ray guidance, spinal neuronavigation, Doppler ultrasound and cardiopulmonary monitoring. An interdisciplinary team of neurosurgeons, cardiothoracic surgeons and anesthesiologists evaluated the patient's case to develop the most suitable therapy concept and alternative strategies. Indication for upper cervical spine surgery and bypass surgery was given. Furthermore, coronary angiography confirmed three-vessel CAD with high-grade coronary artery stenosis. An intradiploic arachnoid cyst in the posterior wall of the posterior fossa was a coincident radiological finding. Computed tomography (CT) scan of the cervical spine revealed a dislocated odontoid fracture Anderson and D'Alonzo type II and an unstable Gehweiler type III injury (Jefferson's fracture).

$jefferson fracture types$

Herein, we report the successful treatment of complex C1/C2 fractures in a patient with concomitant three-vessel coronary artery disease (CAD).Ĭase presentation: A 70-year-old patient presented in our emergency outpatient clinic after a hemodynamic collapse without neurological deficits or heart-related complaints. Therefore, MI can occur together with upper cervical spine trauma.

4Department of Thoracic and Cardiovascular Surgery, University of Tuebingen, Tuebingen, Germanyīackground: Acute myocardial infarction (MI) frequently leads to consciousness disturbance following hemodynamic collapse.

3Department of Diagnostic and Interventional Neuroradiology, University of Tuebingen, Tuebingen, Germany.

2Department of Anesthesiology and Intensive Care Medicine, University of Tuebingen, Tuebingen, Germany.

1Department of Neurosurgery, University of Tuebingen, Tuebingen, Germany.

$jefferson fracture types$

Jefferson fracture types