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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.
In other words, in the axial view, it is the bony mass between the facets that is anterior to the lamina and posterior to the pedicle. It is abnormal in spondylolysis, either due to fracture or congenitally. [1] Bilateral C2 pars fractures are known as a variant of the hangman's fracture.
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)
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
Type I fracture - Extends through the tip of the dens. This type is usually stable. Type II fracture - Extends through the base of the dens. It is the most commonly encountered fracture for this region of the axis. This type is unstable and has a high rate of non-union. Type III fracture - Extends through the vertebral body of the axis.
The atlas (C1) and axis (C2) are the two topmost vertebrae. The atlas (C1) is the topmost vertebra, and along with the axis forms the joint connecting the skull and spine. It lacks a vertebral body, spinous process, and discs either superior or inferior to it. It is ring-like and consists of an anterior arch, posterior arch, and two lateral masses.