Nonoperative management of vertical C2 body fractures.
OBJECTIVE
To estimate the incidence and to describe the clinical results of the nonoperative management of vertical C2 body fractures.


METHODS
An 8-year retrospective review of upper cervical spine injuries from the registry of a level I trauma center identified 21 patients with a vertical C2 body fracture.


RESULTS
Sixteen coronally oriented Type 1 vertical C2 body fractures and 5 sagittally oriented Type 2 vertical C2 body fractures were identified. These fractures account for approximately 10% of the upper cervical spine fractures identified over this period of time. One elderly patient with a Type 1 fracture died as a result of pneumonia, and two patients with Type 2 fractures died from severe closed-head injuries. One patient had evidence of spinal cord injury. This was not related to the C2 body fracture but rather to a subaxial cervical spine injury. Of the surviving 18 patients, all were managed nonoperatively (with external orthoses) and showed evidence of fusion (union of fracture fragments) at the time of the last follow-up.


CONCLUSIONS
Vertical C2 body fractures are not rare injuries and can account for up to 10% of upper cervical spine injuries. In general, vertical C2 body fractures are amenable to nonoperative treatment with external orthoses.
German
John W
JW
Division of Neurosurgery, University of New Mexico, Albuquerque, New Mexico, USA. jwgerman@hotmail.com
Hart
Blaine L
BL
Benzel
Edward C
EC
D000063:Accidents, Traffic; D001368:Axis, Cervical Vertebra / Q000293:injuries* / Q000473:pathology; D001915:Braces; D001270:Cervical Atlas / Q000293:injuries; D003128:Coma / Q000209:etiology; D005596:Fractures, Closed / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D007103:Immobilization; D015994:Incidence; D007405:Intervertebral Disc Displacement / Q000209:etiology; D019547:Neck Pain / Q000209:etiology; D009516:New Mexico / Q000453:epidemiology; D009989:Orthotic Devices; D011379:Prognosis; D011859:Radiography; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000209:etiology; D016103:Spinal Fractures / Q000145:classification / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy*; D016896:Treatment Outcome