{"id":"53d02c2a-6825-4bb4-8b92-b484b6c9b5c4","slug":"contemporaneous-avulsion-fractures-of-the-inferior-clivus-and-bilateral-occipital-condyles-with-injury-of-the-tectorial-membrane","title":"Contemporaneous avulsion fractures of the inferior clivus and bilateral occipital condyles with injury of the tectorial membrane","authors":["Zaid Aljuboori","Mayur Sharma","Norberto Andaluz"],"abstract":"Background: Craniocervical junction (CCJ) injuries are highly variable, and there are only limited data to suggest their optimal treatment. Here, we present a rare case of concomitant bilateral occipital condyle fractures with an inferior clival avulsion fracture with concomitant focal injury of the tectorial membrane. Case Description: Following a motor vehicle accident, a 51-year-old female sustained multiple orthopedic and soft tissue injuries. The cervical computed tomography (CT) showed a bilateral occipital condyle avulsion fractures with an avulsion of the inferior clivus. The cervical magnetic resonance imaging additionally demonstrated focal injury to the tectorial membrane with edema of both atlanto-occipital joints. Although the patient was neurologically intact, the CCJ instability warranted an emergent occiput-C2 (O-C2) posterior instrumented arthrodesis using the modular (multiple piece) occipitocervical (OC) plates/rods. The surgery was uneventful, and the patient remained neurologically intact. The 3-month follow-up cervical X-ray demonstrated continued stability/bony fusion. Conclusion: Bilateral condyle fractures with a concomitant inferior clivus fracture are rare, and there is no known optimal strategy. Here, in an intact patient, instability of the CCJ warranted an O-C2 fusion.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/53d02c2a-6825-4bb4-8b92-b484b6c9b5c4/featured/hero-1781563637926.png","publishDate":"2020-01-17T00:00:00.000Z","doi":"10.25259/SNI_599_2019","categories":["Spine","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/53d02c2a-6825-4bb4-8b92-b484b6c9b5c4/pdf"}