Traumatic injuries of the c1/c2 complex: computed tomographic imaging appearances

Area of Science:

• Orthopedics
• Radiology
• Trauma Surgery

Background:

• Cervical spine fractures represent 1-3% of trauma cases and cause two-thirds of spinal cord injuries.
• Injuries to the C1/C2 complex (atlas and axis) constitute 19-25% of all cervical spine injuries.
• Fractures of the C2 vertebra are most common, with 55% involving the odontoid peg.

Purpose of the Study:

• To describe the anatomy, common anatomical variants, and injury patterns of the atlas and axis.
• To illustrate these findings using computed tomography (CT).
• To review relevant injury classifications for the C1/C2 complex.

Main Methods:

• Review of anatomical descriptions and injury patterns of the atlas and axis.
• Illustration of findings using computed tomography (CT) scans.
• Discussion of common developmental anomalies that may mimic trauma.

Main Results:

• Detailed description of C1/C2 complex anatomy and its unique injury patterns.
• Identification of common fracture types: posterior arch fractures of the atlas, Jefferson fractures, odontoid process fractures, and Hangman's fractures.
• Recognition of traumatic subluxation and rotatory fixation at C1/C2, with or without bone injury.

Conclusions:

• Computed tomography (CT) is crucial for accurately assessing C1/C2 complex injuries.
• Dynamic CT can supplement diagnosis in cases of rotatory fixation.
• Understanding C1/C2 anatomy, variants, and fracture patterns is essential for effective trauma management.