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.

• 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).

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• Treatment: Conservative
• Method: Rigid cervical collar (e.g., Philadelphia collar) for 6–12 weeks
• Monitoring: Serial CT or MRI
• Criteria for stability:
  1. No displacement or angulation
  2. No neurological symptoms
  3. Preserved alignment

• Indications for surgery:
  1. Significant displacement or angulation
  2. Neurological deficits
  3. C2–C3 instability or disc disruption
  4. Failure of conservative management
• Surgical options:
  1. Posterior C2–C3 fixation and fusion (common)
  2. Anterior C2–C3 discectomy and fusion (select cases)

• Higher risk of nonunion with conservative care
• Usually treated with a rigid collar (halo vest less tolerated)
• Surgery considered if progressive symptoms or instability

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