Occipitocervical Fusion and Posterior Fossa Decompression in Neglected Jefferson Fracture-Dislocation of Atlas Associated With Odontoid Peg Fracture: A Case Report.

ABSTRACT

BACKGROUND: Only a few cases of traumatic atlantoaxial fracture-dislocation have been reported, and neglected cases are seldom found because of the fatal nature of this condition. METHODS: We reported a neglected case of Jefferson fracture-dislocation associated with type II displaced odontoid peg fracture which was nonambulatory and myelopathic. A surgical plan involving posterior fossa decompression and laminectomy of the posterior arch of atlas following posterior spinal instrumentation was then conducted. RESULTS: Patient experienced marked neurologic recovery and was able to stand and walk with assistance during the early postoperative period. CONCLUSIONS: This procedure may be an effective alternative treatment in neglected cases.