Axis Body Fracture Treatment [Neurosurgery Wiki]

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====== Axis Body Fracture Treatment ======



<wrap hi>Axis body fractures</wrap> involve the vertebral body of C2 without affecting the dens or pars interarticularis. These are considered **atypical C2 fractures**.

===== 🧠 Key Concepts =====
  * Mechanism: axial loading, flexion-compression, or hyperextension.
  * Sometimes associated with other cervical spine injuries.
  * Stability depends on displacement, comminution, and ligamentous injury (esp. at C2–C3).

<WRAP box 90% center round info>
**Note:** The integrity of the C2–C3 disc space and alignment is critical for assessing stability.
</WRAP>

===== ⬇️ Management Overview =====

<tabs>
=== Stable, Non-displaced Fractures ===
  * **Treatment**: Conservative
  * **Method**: Rigid cervical collar (e.g., Philadelphia collar) for 6–12 weeks
  * **Monitoring**: Serial CT or MRI
  * **Criteria for stability**:
    - No displacement or angulation
    - No neurological symptoms
    - Preserved alignment

=== Unstable or Displaced Fractures ===
  * **Indications for surgery**:
    - Significant displacement or angulation
    - Neurological deficits
    - C2–C3 instability or disc disruption
    - Failure of conservative management
  * **Surgical options**:
    - Posterior C2–C3 fixation and fusion (common)
    - Anterior C2–C3 discectomy and fusion (select cases)

=== Elderly Patients ===
  * Higher risk of nonunion with conservative care
  * Usually treated with a rigid collar (halo vest less tolerated)
  * Surgery considered if progressive symptoms or instability
</tabs>

===== 📊 Summary Table =====

^ Fracture Type              ^ Stability ^ Treatment                              ^
| Non-displaced, stable      | Stable    | Cervical collar, monitor with imaging   |
| Displaced or unstable      | Unstable  | Posterior or anterior surgical fusion   |
| With neurological symptoms | Unstable  | Surgical decompression + fixation       |