Isolated Fractures of the Axis in Adults
Publication Date: March 1, 2013
Last Updated: March 14, 2022
RECOMMENDATIONS
Fractures of the Odontoid
Consideration of surgical stabilization and fusion for type II odontoid fractures in patients ≥50 years of age is recommended. (Level II, )
317039
Initial management of nondisplaced type I, type II, and type III odontoid fractures with external cervical immobilization is recommended, recognizing that a decreased rate of union (healing) has been reported with type II odontoid fractures compared with type I or type III odontoid fractures. (Level III, )
317039
Surgical stabilization and fusion of type II and type III odontoid fractures with dens displacement ≥5 mm, comminution of the odontoid fracture, and/or inability to achieve or maintain fracture alignment with external immobilization are recommended. (Level III, )
317039
If surgical stabilization is elected, either anterior or posterior techniques are recommended. (Level III, )
317039
Traumatic Spondylolisthesis of the Axis (Hangman Fracture)
External immobilization as the initial management of traumatic spondylolisthesis of the axis is recommended. (Level III, )
317039
Surgical stabilization and fusion for the treatment of Hangman fractures in cases of severe angulation of C2 on C3, disruption of the C2-3 disk space, and/or inability to achieve or maintain fracture alignment with external immobilization are recommended. (Level III, )
317039
Fractures of the Axis Body (Miscellaneous Fractures)
External immobilization for the treatment of isolated fractures of the axis body is recommended. Consideration of surgical stabilization and fusion in unusual situations of severe ligamentous disruption and/or inability to achieve or maintain fracture alignment with external immobilization are recommended.. (Level III, )
317039
In the presence of comminuted fracture of the axis body, evaluation for vertebral artery injury is recommended. (Level III, )
317039
Recommendation Grading
Overview
Title
Management of Isolated Fractures of the Axis in Adults
Authoring Organization
Congress of Neurological Surgeons
Publication Month/Year
March 1, 2013
Last Updated Month/Year
March 16, 2023
Document Type
Other
Country of Publication
US
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Diseases/Conditions (MeSH)
D001368 - Axis, Cervical Vertebra
Source Citation
Neurosurgery, Volume 72, Issue suppl_3, March 2013, Pages 132–150, https://doi.org/10.1227/NEU.0b013e318276ee40