PMC5228704_01
Open mouth view X-ray showed lateral displacement of C1 lateral mass which indicting C1 unstable fracture; CT showed multiple fragments of the axis (an unstable odontoid fracture type IIA, traumatic spondylolisthesis of C2-C3, and a C1 burst fracture); MRI showed type IIA transverse atlantal ligament rupture of C1 and an unstable C2-C3.
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F1
Cervical computed tomography (CT) and magnetic resonance imaging (MRI) showed a complex fracture of C2 and a burst fracture of C1, including the rare association of an odontoid type IIA fracture, traumatic spondylolisthesis of C2-C3 type IIA in the modified Levine-Effendi classification, rupture of the C2-C3 disc, and a C1 burst fracture with transverse atlantal ligament rupture (type IIA) (Fig. 1A-H).
Postoperative X-ray and CT showing solid fixation of the unstable fractures.
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F2
The postoperative CT showed sufficient reduction and good positioning of the implants (Fig. 2).
Three months postoperative CT showing fracture healing and C1-C3 fusion.
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F3
At the 3-month follow-up, CT showed fracture healing and C1-C3 fusion (Fig. 3).