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Bilateral C2 pars fractures are known as a variant of the hangman's fracture. On an anterior oblique radiograph of the lumbar spine , the pars is the neck of the imaginary Scottie dog; the Scottie dog's eye is the pedicle, [ 3 ] its hindlegs the spinous process, its nose the transverse process, its ear the superior articular facet and its ...
There are 5 types of C1 fractures referred to as the Levine Classification of Atlas Fractures Type 1: Isolated bony apophysis (transverse process fracture Type 2: Isolated posterior arch fractures Type 3: Isolated anterior arch fracture Type 4: Comminuted fracture of the lateral mass Type 5: Bilateral burst fracture (AKA Jefferson Fracture)
The C2 fracture accounts for nearly 19% of spinal fractures [10] and 55% of cervical fractures (in patients with head injury). Within C2 fractures, the hangman's fracture accounts for 23% of occurrences while the odontoid or dens fracture accounts for 55% of them. [2]
It is ring-like and consists of an anterior arch, posterior arch, and two lateral masses. The axis (C2) forms the pivot on which the atlas rotates. The most distinctive characteristic of this bone is the strong odontoid process (dens) that rises perpendicularly from the upper surface of the body and articulates with C1.
There are three atlanto-axial joints: one median and two lateral: [2] The median atlanto-axial joint is sometimes considered a triple joint: [3] one between the posterior surface of the anterior arch of atlas and the front of the odontoid process; one between the anterior surface of the ligament and the back of the odontoid process
Lateral displacement is called lateral listhesis [4] or laterolisthesis. [ 5 ] A hangman's fracture is a specific type of spondylolisthesis where the second cervical vertebra (C2) is displaced anteriorly relative to the C3 vertebra due to fractures of the C2 vertebra's pedicles .
C1 is also called the atlas, and C2 is also called the axis. The structure of these vertebrae is the reason why the neck and head have a large range of motion. The atlanto-occipital joint allows the skull to move up and down, while the atlanto-axial joint allows the upper neck to twist left and right. The axis also sits upon the first ...
The Hangman's fracture which is a fracture of the C2 vertebral body or dens of the cervical spine upon which the skull base sits to allow the head to rotate, can also be associated with atlanto-occipital dislocation. Despite its eponym, the fracture is not usually associated with a hanging mechanism of injury. [13]