Meyer Type III Vertical Atlantoaxial Distraction with Complete Ligamentous Disruption: A Case Report and Surgical Management.
Ali Hammed, Veit Braun
✦ AI-curated · Sources linked
Case in brief
A 33-year-old man sustained multiple injuries after a 10 m fall, including Meyer Type III vertical atlantoaxial distraction with 6 mm separation between the C1 and C2 lateral masses. Imaging showed complete disruption of several ligamentous stabilizers, bilateral facet capsule disruption, a C1 anterior arch fracture, and a traumatic dural tear with suspected CSF leak. After initial anterior stabilization, clinical instability prompted posterior C1/C2 fusion one week later. Surgeons corrected a 10-degree rotational deformity and repaired the dura. He remained neurologically intact; follow-up showed stable fixation, and at 6 years he retained cervical rotation up to 50 degrees.
What made this case unusual
The injury combined complete ligamentous disruption and a traumatic dural tear with suspected CSF leak, alongside a C1 fracture and rotational deformity.
Diagnostic / clinical pearl
High-resolution imaging can define the extent of ligamentous and associated dural injury in vertical atlantoaxial distraction, informing classification-based stabilization and operative planning.