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Chapter: Neuro

Subchapter: Spine (Read entire chapter)

Diagnosis: Hangman`s fracture
Lateral cervical radiograph of the cervical spine (left and bottom right = magnification) shows an irregular, linear lucency through the posterior elements of C2. There seems to be mild angulation at C2/C3 and the spinolaminar line is slightly offset at C2. Furthermore, there is thickening of the upper prevertebral soft tissues (asterisk), measuring about 10 mm at the level of the base of the dens. Axial CT image (top right) through the level of C2 shows a fracture through the bilateral pedicles, with the left pedicle fracture extending through the left foramen transversarium.
Hangman`s fracture is an unstable bilateral pedicle fracture of C2, typically with traumatic spondylolisthesis of C2-3. Common mechanism is hyperextension.

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