(e) Lateral radiograph showing adequate alignment after treatment with halo-vest. Optimal angles for visualizing lower cervical foramina are larger than those for upper cervical spine, and oblique cervical radiographs should be obtained. The fracture line in the body of the axis is also observed (curved arrows). Also note the absence of right C2-C3 articular space (long arrow) and fusion of laminae. The posterior arch of C1 is incomplete (short arrow). The fracture line in the posterior elements runs through supero-anterior border of the pars and foramina transversarium (straight arrow). This image shows the fracture in the body of C2 (curve arrow). The presence of sclerosis of both borders indicates that this is not a fracture. There is an absence of midline fusion of anterior C1 arch (white arrow). Note the C2-C3 intervertebral space fusion (black arrow). The fracture line divides obliquely the axis vertebra in two fragments. The fracture line extends obliquely from posterior elements to the vertebral body (white arrows). An oblique fracture of the axis is observed. Keywords: C2 fracture, craniovertebral congenital anomalies, Klippel–Feil syndrome, miscellaneous axis fractures, oblique axis fracture Following treatment in a halo vest, the patient maintained alignment, and ultimately the fracture was fused.Ĭonclusions:True oblique fractures of the axis are rare, as in the case presented, and may occasionally occur in conjunction with KFS of the upper cervical spine. Here, the authors present an unusual oblique axis fracture occurring in conjunction with several malformations of the upper cervical spine.Ĭase Description:Following a motor vehicle accident, a 25-year-old female's radiographic studies showed an oblique axis fracture involving both the anterior and posterior elements along with an anterior and posterior Klippel–Feil syndrome (KFS) anomaly. Congenital malformations of the craniovertebral junction (CVJ), although typically asymptomatic, may result in neural compression or instability, especially following trauma. They are usually classified into three different types, namely, odontoid fractures, Hangman's fractures, and miscellaneous fractures. Background:Acute traumatic axis fractures are common cervical spine injuries often caused by road accidents or falls.

Oblique upper cervical spine x ray