Traumatic Injuries of the C1/C2 Complex: Computed Tomographic Imaging Appearances

Pratt, Hazel; Davies, Evan; King, Leonard

doi:10.1067/j.cpradiol.2007.07.001

Cited by 25 publications

(14 citation statements)

References 18 publications

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“…The plurality of these injuries occur at C2, 80% of which are odontoid (dens) fractures or traumatic spondylolistheses (so-called Hangman fractures). [1][2][3][4][5] Both have well-accepted, long-standing classification schemes. 4,6 -10 Clinical research has indicated that radiographic treatment outcomes, such as bone healing and risk for instability, are prognosticated by classification type and variables such as angulation and displacement.…”

mentioning

confidence: 99%

Observer Variability of Radiographic Measurements of C2 (Axis) Fractures

Bono

Schoenfeld²,

Anderson³

et al. 2010

Spine

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mentioning

confidence: 99%

Observer Variability of Radiographic Measurements of C2 (Axis) Fractures

Bono

Schoenfeld²,

Anderson³

et al. 2010

Spine

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“…1,2 There are magnetic resonance imaging tests that suggest that interruption of the alar ligament is the mechanism by which a rotatory subluxation is produced. 15,16 The alar ligaments are the main structures responsible for the stability of rotation, as they limit the rotation to 45°. 5,14 Fielding and Hawkins 10 describe 4 types of atlantoaxial rotation with rotation of the transversal ligament.…”

Section: Discussionmentioning

confidence: 99%

Traumatic atlantoaxial subluxation, posterior transfacet fixation: a case report

2015

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Cervical spine injuries are often described as catastrophic events in neurological terms, with very low survival rate. Lesions to C3-C7 segment are the most common (about 80%) followed by segment C1-C2 (20%). The cervical spine injuries are of great importance, both by severity as the neurological implications. It is important to consider that among cervical traumas that do not present neurological damage at the time of the accident, 10% have deficits later, so all cervical trauma should be considered as potential spinal cord traumas, until the evolution of the case shows that definitively there is no spinal cord or nerve root damage. Cases have been reported with both atlantooccipital and atlantoaxial dislocations without neurological deficit, so these lesions went unnoticed in the emergency services. Some of the events to be considered at the time of the accident are suboccipital pain on axial skull pressure and spontaneous stiffness of the patient's neck. Dysphagia, pain on palpation of the anterior neck and a visible increase of prepharyngeal mass can also be observed, which is why it is important to keep the suspicion of craniocervical trauma in all patients who have these symptoms and carry out the relevant tests. This paper presents a case of post-traumatic atlantoaxial dislocation, which showed no neurological deficit at the time of the accident, but was later presented, as well as the surgical procedure carried out.

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“…10,11 The unique characteristics of this case are the fracture pattern involving the anterior arch of the atlas combined with the type II odontoid fracture, and its nonoperative management with good functional outcome at 1 year. Only 2 similar reports have been found in the literature.…”

Section: Discussionmentioning

confidence: 99%

Combined Type II Odontoid Fracture With Axis Anterior Arch Fracture

Malagelada

Tibrewal

Lucar

et al. 2014

Geriatr Orthop Surg Rehabil

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Associated fractures of the atlas and axis are frequent, particularly in the elderly patients following a simple low-energy fall. This injury can be easily misdiagnosed on initial plain radiographs, and therefore computed tomography scan is a useful adjunct in patients with a degenerative spine. There is still no consensus as to the optimal treatment of combined axis-atlas fractures, and the majority of authors propose a therapeutic strategy dependent on the odontoid fracture pattern. We describe a combined atlas and axis fracture in a 92-year-old patient who was managed with nonoperative treatment in a rigid collar. The association of C1 anterior arch with a C2 type II odontoid fracture is a rare combination, which to our knowledge has never been reported following nonoperative treatment. There was a good functional outcome at 1-year follow-up with the fracture progressing to a fibrous nonunion of the odontoid process.

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Traumatic Injuries of the C1/C2 Complex: Computed Tomographic Imaging Appearances

Cited by 25 publications

References 18 publications

Observer Variability of Radiographic Measurements of C2 (Axis) Fractures

Observer Variability of Radiographic Measurements of C2 (Axis) Fractures

Traumatic atlantoaxial subluxation, posterior transfacet fixation: a case report

Combined Type II Odontoid Fracture With Axis Anterior Arch Fracture

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