C1 Lateral Mass Fracture

Contributed by: James Demetrious, DC, FIANM

A 77-year old woman fell backwards striking the back of her head on a concrete floor. She sought the care of her PCP. X-rays read by an attending radiologist revealed DJD with no acute abnormalities. Patient presents for chiropractic care due to worsening sub-occipital pain. Acute pain is elicited upon palpation of the C2 spinous process.

Review of medical x-rays reveal a compression fracture of the right C1 lateral mass. Subsequent MRI reveals increased signal intensity of the C1 lateral mass and C2 vertebra. CT was recommended but not performed. Neurosurgeon recommended observation without surgical intervention.