Case report: Interdisciplinary treatment of complex C1/C2 fractures in a patient with concomitant three-vessel coronary artery disease requiring bypass surgery

This case report discusses the challenging treatment of a 70-year-old patient who suffered complex fractures of the C1 and C2 vertebrae (upper cervical spine) along with severe coronary artery disease (CAD). The patient's CAD required bypass surgery, complicating the treatment plan for the spinal fractures. The patient's case was evaluated by an interdisciplinary team including neurosurgeons, cardiothoracic surgeons, and anesthesiologists to determine the best course of action, considering both the spinal injuries and the heart condition. Ultimately, the patient underwent C1-C2 fusion surgery to stabilize the spine, followed by bypass surgery one month later. The patient recovered well from both procedures without developing neurological deficits.

• 1
  The patient presented with a dislocated odontoid fracture and an unstable Jefferson’s fracture, along with a coincident intradiploic arachnoid cyst and severe three-vessel coronary artery disease.
• 2
  An interdisciplinary approach was crucial in developing a suitable therapy concept, involving careful consideration of the risks and benefits of different treatment strategies.
• 3
  C1-C2 fusion was successfully performed using the Harms technique, followed by bypass surgery one month later, with the patient recovering completely from both surgeries without neurological deficits.