C1 isolated posterior arch fracture

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  • Stable cervical spine fracture
    • Anterior arch and transverse ligament are unaffected
  • Also called a Landells Atlas Type I fracture
  • Rule out burst fracture

Vertebral fractures and dislocations types

Vertebral anatomy.
Numbering order of vertebrae.

Clinical Features

  • Due to forced neck extension

Differential Diagnosis

Neck Trauma


  • Vertical fracture line through posterior arch seen on lateral x-ray
  • CT test of choice to evaluate for associated fractures
  • MRI can evaluate ligamentous injury (transverse ligament is primary AA junction stabilizer)



  • Usually discharge (if truly isolated) in consultation with neurosurgery

See Also