CT of dens axis fractures

Area of Science:

• Orthopedic surgery
• Radiology
• Trauma care

Background:

• Dens axis fractures are common cervical spine injuries.
• Classification of these fractures impacts treatment and prognosis.
• Subtle fractures, particularly Type II, can be missed on initial imaging.

Purpose of the Study:

• To highlight the importance of differentiating dens axis fracture types.
• To emphasize the diagnostic utility of reformatted and axial CT imaging for specific fracture patterns.

Main Methods:

• Review of dens axis fracture classifications.
• Analysis of imaging findings on plain films versus CT scans.
• Focus on Type II and Type III dens axis fractures.

Main Results:

• Type II fractures at the dens base may be overlooked without reformatted images.
• Type III fractures extending into the vertebral body can cause spinal canal rotation.
• Axial CT effectively visualizes spinal canal rotation associated with Type III fractures, often missed on plain films.

Conclusions:

• Distinguishing dens axis fracture types is critical for appropriate management.
• Axial CT is essential for identifying rotational instability in Type III fractures.
• Advanced imaging techniques improve the detection of complex dens axis injuries.