{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T10:57:15Z","timestamp":1772103435244,"version":"3.50.1"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"S 01","license":[{"start":{"date-parts":[[2020,3,20]],"date-time":"2020-03-20T00:00:00Z","timestamp":1584662400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B Skull Base"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>C1 fractures with an intact transverse ligament are usually treated conservatively. Patients who present with a progressive diastasis of bone fragments and a progressive articular subluxation mainly attributed to progressive lengthening of the transverse ligament (TAL) fibers can be treated with a C1 \u201cC-clamp\u201d fusion.<\/jats:p><jats:p>A 75-year-old male who sustained a motor vehicle accident was neurologically intact. A computed tomography (CT) imaging demonstrated a Jefferson's type-C1 fracture with a slight lateral displacement of the C1 left lateral mass (LM) and a rotatory subluxation on the right. MRI showed an intact TAL and demonstrated an isolated rupture of the left alar ligament. Conservative treatment was chosen. Radiographic follow-up showed, at 3 months, progressive lateral mass displacement, most likely due to elongation of the TAL fibers; this was also associated with a persistent mechanical neck pain. For this reason, we performed a posterior reduction and internal fixation in a C-clamp fashion by placement of C1 lateral mass screws and posterior compression sparing the C1\u20132 joint. Using navigation, a 3.5-mm screw was inserted into the LM bilaterally. The screw heads were then connected with a rod and compression was applied before tightening. Postoperative CT scan demonstrated a satisfying reduction and further imaging will be made during the follow-up. The patient had a considerable relief of neck pain. Simple lateral mass fixation with C-clamp technique is a reasonable option in case of isolated C1 fractures in patients who have failed conservative management while preserving the range of motion (ROM) at the atlanto\u2013axial joint.<\/jats:p><jats:p>The link to the video can be found at: https:\/\/youtu.be\/x8bsVwzCt_M.<\/jats:p>","DOI":"10.1055\/s-0040-1701692","type":"journal-article","created":{"date-parts":[[2020,3,31]],"date-time":"2020-03-31T21:10:37Z","timestamp":1585689037000},"page":"S61-S62","source":"Crossref","is-referenced-by-count":3,"special_numbering":"S","title":["Navigation-Assisted Posterior Open Reduction and Internal Fixation in a C-CLAMP Fashion for an Isolated C1 Fracture"],"prefix":"10.1055","volume":"82","author":[{"given":"Daniele","family":"Starnoni","sequence":"additional","affiliation":[{"name":"Neurosurgical and Spine division, Centre Hospitaliere Universitaire Vadois, Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timo","family":"Ecker","sequence":"additional","affiliation":[{"name":"Neurosurgical and Spine division, Centre Hospitaliere Universitaire Vadois, Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2515-5810","authenticated-orcid":false,"given":"Juan","family":"Barges-Coll","sequence":"additional","affiliation":[{"name":"Neurosurgical and Spine division, Centre Hospitaliere Universitaire Vadois, Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,3,20]]},"container-title":["Journal of Neurological Surgery Part B: Skull Base"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0040-1701692.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,8]],"date-time":"2021-03-08T11:41:07Z","timestamp":1615203667000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0040-1701692"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,20]]},"references-count":0,"journal-issue":{"issue":"S 01","published-online":{"date-parts":[[2021,3,5]]},"published-print":{"date-parts":[[2021,2]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0040-1701692","relation":{},"ISSN":["2193-6331","2193-634X"],"issn-type":[{"value":"2193-6331","type":"print"},{"value":"2193-634X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,3,20]]}}}