C1 fractures: a review of diagnoses, management options, and outcomes

Loren B. Mead, Paul W. Millhouse, Jonathan Krystal, Alexander R. Vaccaro

Research output: Contribution to journalReview articlepeer-review

41 Scopus citations


The atlas is subject to fracture under axial load, often due to traumatic injuries such as shallow dives and automobile accidents. These fractures account for 2–13 % of injuries to the cervical spine [Marcon RM et al. Clinics (Sao Paulo) 68(11):1455-61, 2013]. Fractures of the C1 vertebra are often difficult to diagnose, as there is often no neurological deficit or easily identifiable findings on radiographs. However, injuries to the atlas can be associated with vertebral artery injury and atlantoaxial or atlanto-occipital instability, making prompt and accurate diagnosis imperative. A detailed understanding of the anatomy, inherent stability, and common injury patterns is essential for any surgeon treating spinal trauma. This chapter explores the diagnosis and management of C1 fractures, as well as outcomes after treatment.

Original languageEnglish (US)
Pages (from-to)255-262
Number of pages8
JournalCurrent Reviews in Musculoskeletal Medicine
Issue number3
StatePublished - Sep 1 2016
Externally publishedYes


  • Atlantoaxial instability
  • Atlas fracture
  • C1
  • Jefferson fracture
  • Transverse odontoid ligament
  • Upper cervical spine

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine


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