My Orthopaedic Surgeon

This area of the upper cervical spine is extremely mobile, and its stability is dependent on ligamentous structures. In unresponsive patients or those who are unable to report symptoms or pain, a C1 fracture or an occipital cervical dislocation must be excluded by radiographic screening. Also, displacement of the C1 ring may occur if the capsule or ligaments are disrupted, even without a C1 fracture; hence, the head may be displaced on the neck, and the atlas may also rotate around the odontoid or sustain a fracture of the dens.
Synonyms and related keywords: C-1 fractures, cervical fracture, Jefferson's fracture, Jefferson fracture, axial burst fracture of the atlas, spine fracture, broken neck
Foster 2006

Cervical spine (C-spine) injuries are the most feared of all spinal injuries because of the potential for significant deleterious sequelae. Correlation is noted between the level of injury and morbidity/mortality (ie, the higher the level of the C-spine injury - the higher the morbidity and mortality). Craniocervical junction injuries are the deadliest. As many as 10% of unconscious patients who present to the emergency department following a motor vehicle accident (MVA) have C-spine pathology. MVAs and falls are responsible for the bulk of C2 fractures. The clinical manifestations range from asymptomatic to frank paralysis. This article focuses on the uniqueness of and the most common types of traumatic C2 (axis) fractures.
Igor Boyarsky, DO, Gary Godorov, MD

Cervical spine fractures lead to substantial morbidity and mortality. Neck injury in athletes can quickly end or change the future of an athlete. Failure to properly recognize and provide early care in cervical spine fracture cases may lead to devastating complications.
ynonyms and related keywords: cervical spine fracture, neck fracture, spinal injury, neck injury, spinal trauma
George L Hertner, MD, Nathaniel Johnson Stewart, Jr, MD, FACEP, Mark J Leski, MD

Approximately 5-10% of unconscious patients who present to the ED as the result of a motor vehicle accident or fall have a major injury to the cervical spine. Most cervical spine fractures occur predominantly at 2 levels. One third of injuries occur at the level of C2, and one half of injuries occur at the level of C6 or C7. Most fatal cervical spine injuries occur in upper cervical levels, either at craniocervical junction C1 or C2
Jorma B Mueller, MD, Moira Davenport, MD, Simon Roy, MD

One of the most challenging roles of the team physician involves the intervention and decision-making processes regarding cervical spine (C-spine) injuries in contact sports. The team physician must be well versed in the prevention, evaluation, stabilization, and treatment of C-spine injuries. A high index of suspicion and an understanding of cervical alignment and architecture, as well as comprehension of the mechanics exerted during a sporting event, are imperative to diagnosing cervical injuries.
Synonyms and related keywords: C-spine injuries, back injury, sports-related spinal injury, sports-related spine injury, sports-related back injury, neck injury, sports-related neck injury
Andrew A Sama, MD, Federico P Girardi, MD, Frank P Cammisa, Jr, MD

A patient with thirty years history of ankylosing spondylitis sustained a head and neck injury after a fall.He was transmitted to the emergency department .His GCS was 15 with no findings in neurological examination.He had x-rays of the head and neck which considered normal and the patient discharged from the hospital.The patient for the next three months complained for neck pain and numbness of the upper arms
and had new x-rays and MRI which revealed a burst fracture of C7 vertebra.The patient is treated in a cervical collar Philadelphia type and is examined every month.
Fractures of cervical spine are obtained easily in patients with ankylosing spondylitis even after a minor trauma  due to osteoporosis and altered embiomechanics . Most of them have fractures in the C6-C7 vertabra and are three- column fractures.Doctors must have in mind this serious complication of ankylosing spondylitis 

Accepted radiology practice for the US military. Les Folo, DO, MPH

May be clinically & radiographically similar to flexion teardrop fracture;
- its important to distinguish these two, since, neurologic deficits assoc w/ burst fracture may be transient & therefore have better prognosis than deficits resulting from a flexion injury;
- features of burst fracture include disruption & vertical fracture thru body, posterior element frx, anterior wedge deformity, & retropulsed fragments w/ varying degrees of narrowing of canal as a result of fragments;

Injuries of the subaxial cervical spine (C3-7) are among the most common and potentially most devastating injuries involving the axial skeleton. Assume a cervical spine injury is present until proven otherwise in patients presenting to an emergency facility with a history of a high-speed motor vehicle accident, significant head or facial trauma, a neurologic deficit, or neck pain.
Synonyms and related keywords: compression fractures, burst fractures, teardrop fractures, unilateral facet fracture dislocations, unilateral jumped facet, bilateral facet fracture dislocations, jumped facets, lamina fractures, spinous process fractures, clay shoveler's fracture
Jacob Goodrich, MD, Thad Riddle, MD,

Management of Acute Odontoid Fractures: Operative Techniques and Complication Avoidance from Neurosurg Focus 8(6), 2000.
Shushil Shilpakar SK, M.D., Mark R. Mclaughlin, M.D., Regis W. Haid, Jr. M.D., Gerald E. Rodts, Jr., M.D., Brian R. Subach, M.D., Tribhuvan University Teaching Hospital, Kathmandu, Nepal; and The Emory Clinic, Emory University Hospital, Atlanta, Georgia
Abstract In this article the authors describe the management of Type II odontoid fractures with special attention to operative technique and avoidance of complication. Anterior odontoid screw fixation is a procedure the authors have performed over the last 8 years in cases with acute Type II and rostral Type III odontoid fractures. In cases of Chronic Type II odontoid fractures and in patients with transverse ligament disruption, the authors prefer to undertake posterior transarticular facet screw fixation supplemented by bone graft and interspinous C1-2 wiring. The technical aspects of these procedures are described with a focus on operative nuances. Selection criteria and techniques that the authors have refined over the years have helped them to optimize success rates and minimize complications.