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

Clinical Features

• Due to forced neck extension

Differential Diagnosis

Vertebral fractures and dislocations types

Vertebral anatomy.

Numbering order of vertebrae.

• Cervical fractures and dislocations
  • Atlanto-occipital dissociation
  • C1
    • Jefferson fracture
    • C1 isolated anterior arch fracture
    • C1 isolated posterior arch fracture
  • C2
    • Odontoid fracture
    • Hangman's fracture
  • C3-C7
    • Cervical burst fracture
    • Cervical spinous process fracture
    • Extension cervical teardrop fracture
    • Flexion cervical teardrop fracture
    • Anterior cervical wedge fracture
  • Cervical facet dislocation
  • Isolated transverse process fracture
• Thoracic and lumbar fractures and dislocations
  • Chance fracture
  • Thoracic burst fracture
  • Lumbar burst fracture
  • Isolated transverse process fracture
  • Thoracic and lumbar compression fractures

Workup

• Must ensure that you are not confusing this with a burst fracture
  • Odontoid view must be normal

• Vertical fracture line through posterior arch seen on lateral xray

Management

• Prehospital Immobilization see NAEMSP National Guidelines for Spinal Immobilization

See Also

• Cervical spine injuries