Thus, these fractures are treated with external immobilization with a halo vest or surgery. Type II and III fractures are considered unstable and are frequently complicated by nonunion due to the poor vascularity of the area. Type I fractures can be treated with cervical arthrodesis for three months. MRI can better demonstrate soft-tissue (ligaments and cartilage) and spinal cord injuries. However, in low-risk patients with suspected cervical injury, there is not enough evidence that CT should replace radiography. Consequently, multidetector CT of the cervical spine is usually included in the total body screening of patients with severe trauma. CT has been shown to be 98% sensitive in detecting spine injury in high-risk patients whereas radiography was 52% sensitive. MPR images may reveal fractures not visible on axial images due to their plane. ĬT can be used as primary imaging modality in multiorgan trauma patients or when plain radiographies are inadequate. This membrane of granulated tissue forms most often as a result of rheumatoid arthritis, in. Swelling of the prevertebral soft-tissue (with thickness greater than 7mm) and disruption of the ring of C2 (Harris’s ring) are indirect signs of fracture on the lateral radiograph, with the latter raising suspicion of a type III fracture. The odontoid process serves as the pivot point for turning the head. When evaluating a lateral radiography, the distance between the anterior surface of the dens and the anterior arch of atlas must not exceed 3mm in adults and 5mm in children and the posterior surface of the dens must form a continuous line with the posterior surface of the body of the C2. RA cervical pannus with odontoid destruction and concomitant calcium pyrophosphate dehydrate deposits (A) MRI demonstrating enhancing odontoid pannus (asterisk).(B) CT image reveals cyst-like osseous destruction of the odontoid process (asterisk). The fracture line and the displacement of the distal fragment are the two direct signs of DF in radiography.

The Canadian C-spine rule can be used when examining patients suspected of cervical spine fracture to decide whether imaging is needed or not. ĭue to aging, the pain may be minimal in old patients where the neurologic deficit must be taken into account. Type I refers to a fracture involving the superior part of the odontoid process while Type II involves its base and Type III affects the body of C2. ĭens fractures (DF) constitute the commonest type of fracture of the cervical spine, representing 5-15% of all cervical spine fractures and are divided in three types. Injury of the cervical spine is usually caused by vehicle accidents, diving into shallow water and athletic activities and affects patients under 24 years and older than 55 years of age.

Odontoid processes