College Football Player with Unstable C1 Fracture: A Case Report

Bales et al present a case of a 20-year-old National Collegiate Athletic Association Division college football player, who suffered a cervical spine injury during the first half of a football game. Playing the linebacker position, the player was injured while helping to make an open field tackle. Upon presentation the following day at the university sports medicine office, the player complained of worsening neck pain, inability to sleep, and limitations in neck range of motion. Axial and coronal CT images demonstrated a burst-type C1 fracture with significant displacement of the lateral masses. No vascular injury was found; however, a hypoplastic left vertebral artery was identified. Because of the significant displacement of the fragments, this fracture was considered unstable and was treated with a C1-C2 fusion using transarticular screw fixation.