Pediatric Jefferson Cervical Spine Fracture

  • Etiology: Trauma
  • Imaging: Fractures through anterior and posterior arches of C1 leading to the C1 vertebral body having a wider diameter than C2 vertebral body and an asymmetry between odontoid process and lateral masses of C1
  • DDX:
  • Complications:
  • Treatment:
  • Clinical:

Radiology Cases of Jefferson Cervical Spine Fracture

CT of fracture of C1 vertebral body / Jefferson fracture
Axial CT without contrast of the cervical spine shows lucencies through the left anterior and posterior arches of the C1 vertebral body with minimal displacement of the fracture fragments.
CT of fracture of C1 vertebral body / Jefferson fracture
Axial CT without contrast of the cervical spine (upper left) shows lucencies through the left anterior and posterior arches of the C1 vertebral body with displacement of the fracture fragments. Coronal 2-D reconstruction (lower left) and the 3-D reconstruction (right) which simulates an open-mouth odontoid radiograph shows the lateral masses of the C1 vertebral body are now wider than the lateral masses of the C2 vertebral body.
CT and MRI of pediatric Jefferson fracture of cervical spine
Axial CT without contrast of the cervical spine (above) shows a jagged non-corticated lucent line through the anterior aspect of the C1 vertebral body just to the left of midline. The posterior arch of C1 is not fused yet. Axial T2 MRI of the C1 vertebral body (below left) shows hyperintense signal in the anterior aspect of the C1 vertebral body in the same area as the lucent line seen on CT, as well as bright signal in the anterior arch of C1 representing bone marrow edema. Sagittal T2 MRI of the cervical spine (below right) shows prevertebral edema anterior to the C2 vertebral body.