Primary treatment of unstable Jefferson's fractures

The Magerl transfacet screw technique is a method of fixation for unstable burst fractures of the atlas (Jefferson's fracture) that precludes the use of a halo brace or stabilization from the occiput to C2. Two cases are presented utilizing this mode of treatment to obtain solid arthrodesis and maintain intact motion at occipital cervical junction. No increased displacement of the fractured ring of C1 occurred with the screw insertion. Thus, primary C1-C2 transfacet screw fixation is a useful alternative treatment for unstable Jefferson's fractures.