Imaging of the Cervical Spine > Management > Management of Specific Fractures

Management of Specific Fractures

Fracture of atlas:

Jefferson fracture is treated with halo immobilization for 12 weeks, which usually results in primary union of the ring of C1 and stability of C1 with respect to C2. Surgical fusion may be needed if there is atlantoaxial instability after removal of halo.

Fractures of axis:

Odontoid fracture:
Type I is rare. It usually does not have any neurologic symptoms. It is treated with Philadelphia collar.
Type II is the most difficult type to treat in the halo vest. Even with proper management, the nonunion rate is still as high as 30-60%. If nonunion persists, surgical posterior fusion is indicated.
Type III is treated with halo immobilization. It usually has a high rate of union.

Hangman's fracture is unstable. It usually heals with halo immobilization for 12 weeks. Surgical fusion is rarely indicated.

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