Traumatic posterior atlantoaxial dislocation with associated C1 Jefferson fracture and bilateral vertebral artery occlusion without odontoid process fracture or neurological deficit.

PURPOSE: Traumatic atlantoaxial dislocation (AAD) is usually associated with fatal high-velocity road traffic accidents (Xu et al. in Medicine (Baltimore) 94:e1768, 2015). There are few reports of survival following posterior AAD without odontoid fracture (Xu et al. 2015; Zhen et al. in Arch Orthop Trauma Surg 131:681-685, 2011; de Carvalho and Swash in Handb Clin Neurol 119:435-448, 2014).

METHOD: We present a previously undescribed case of posterior AAD associated with a C1 Jefferson fracture but no odontoid fracture and bilateral vertebral artery occlusion without neurological deficit.

CONCLUSION: The presence of bilateral vertebral artery occlusion raised challenges in the surgical management. Survival was only possible due to the presence of robust cerebral collateral circulation.