ABSTRACT
Almost 20% of acute cervical spine fractures involve the C2 vertebra (1). Fractures of the axis include three types: odontoid fractures, traumatic spondylolisthesis of the pars interarticularis, or ‘‘hangman’s fractures,’’ and miscellaneous fractures (Fig. 1).
I ANATOMY The occipitocervical junction is a complex array of bony and ligamentous structures, and therefore a C2 fracture should not be considered as an isolated bony injury. The body of C2 is the largest of the cervical vertebrae. Its superior articular processes are anterior in the sagittal plane to its inferior articular processes, and articulate with the inferior articular processes of C1. This joint complex provides for approximately 50% of the rotation of the entire cervical spine (2). The inferior articular processes have a similar sagittal orientation as the other subaxial cervical vertebrae and provide limited flexion, tilt, and rotation at its articulation with C3.
