A missed Jefferson fracture in chiropractic practice

G A Regelink, A de Zoete

Research output: Contribution to JournalArticleAcademicpeer-review


OBJECTIVE: To review the case of a missed cervical spine fracture in a patient with neck pain.

CLINICAL FEATURES: A 21-year-old thatcher with neck pain presented to a chiropractic clinic after a fall from a roof 4 m high. The hospital radiographs were read as normal. The chiropractor suspected a Jefferson fracture of the atlas after evaluation of the same radiographs.

INTERVENTION AND OUTCOME: The chiropractor retook the anteroposterior open-mouth radiograph to confirm the suspected fracture. The patient was referred for further imaging and underwent neurosurgical treatment, after which he recovered well.

CONCLUSION: Normal radiologic reports from a hospital cannot be relied on for contraindications to manipulative treatment in all instances, as shown in this case of a missed fracture. Chiropractors should therefore always evaluate radiographs that are brought to them.

Original languageEnglish
Pages (from-to)210-3
Number of pages4
JournalJournal of Manipulative and Physiological Therapeutics
Issue number3
Publication statusPublished - 21 Apr 2001


  • Adult
  • Cervical Vertebrae/diagnostic imaging
  • Chiropractic
  • Diagnostic Errors
  • Fractures, Bone/diagnostic imaging
  • Humans
  • Male
  • Netherlands
  • Tomography, X-Ray Computed

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