====== Axis Body Fracture Treatment ====== Axis body fractures 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). **Note:** The integrity of the C2–C3 disc space and alignment is critical for assessing stability. ===== ⬇️ Management Overview ===== === 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 ===== 📊 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 |