axis fracture classification

X-ray of the

cervical spine with a Hangman"s fracture. Left without, right with annotation. C2 (outlined in red) is moved forward with respect to C3 (outlined in blue).

Teenager in

motor vehicle accident with neck painSagittal (left) and coronal (right) 2D reconstructions from a CT without contrast of the cervical spine shows an oblique lucency through the C2 vertebral body with distraction of the fracture fragments. There is marked prevertebral soft tissue swelling throughout the cervical spine.The diagnosis was a fracture-distraction of C2.

Behandlung

einer instabilen Densfraktur: Spondylodese HWK 1 / 2 mit dorsalem Fixateur interne. Die Pedikelschrauben sind gekreuzt eingebracht. Der hintere Atlasbogen wird von den Klammern umfasst. Zusätzlich Spongiosamaterial angelagert.

Pseudarthrose

nach Densfraktur. Im Gegensatz zum Os odontoideum hier normale Größe des Densfragments. Die kortikalisierten Ränder lassen eine frische Fraktur ausschließen.

Teenager in

motor vehicle accident with neck painAxial CT without contrast of the cervical spine (top) shows a lucency extending through the left C2 facet and another lucency extending through the right transverse process and involving the right transverse foramen which raised concern for possible right vertebral artery injury which was ruled out on a subsequent CT angiogram of the neck. Sagittal 2D reconstructions from the left, center and right of the cervical spine shows lucencies through the left C2 facet (left image), right transverse process (right image) and anterior inferior aspect of the C2 vertebral body (center 2 images).The diagnosis was a fracture of C2 (Hangman fracture) without anterolisthesis of C2 on C3.

School ager

in motor vehicle accident with neck painAxial CT without contrast of the cervical spine (upper left) shows lucencies through both pedicles of the C2 vertebral body. Midline sagittal 2D reconstruction (upper right) shows anterior dislocation of the C2 vertebral body on the C3 vertebral body. Left sagittal (lower left) and right sagittal 2D reconstructions (lower right) again show lucencies through the bilateral C2 pedicles and bilateral anterior perching of the C2 inferior facets on the C3 vertebral body.The diagnosis was fracture / dislocation of the C2 vertebral body with bilateral perched facets (Hangman fracture).