Presentation
Fall backwards from standing height. Neck pain.
Patient Data
Oblique type 2 fracture of the C2 odontoid process with 4 mm posterior displacement of the superior fragment. Adjacent hematoma results in mild spinal canal narrowing. Grade 1 retrolisthesis of C1 on C2.
No further fracture identified. The remaining vertebral alignment and vertebral height appears maintained. Multilevel intervertebral disc degeneration and bilateral facet joint arthropathy.
Prevertebral soft tissue swelling at the level of the anterior C1 arch measuring 11 mm.
Impression
Oblique type 2 fracture of the C2 odontoid process with 4 mm posterior displacement of the superior fragment resulting in mild spinal canal narrowing. Grade 1 retrolisthesis of C1 on C2.
Case Discussion
The odontoid process injury represents a type 3 Anderson and D'Alonzo fracture as it involves the lateral masses. Given the oblique orientation of the fracture with posterior translation of the peg, it constitutes a type 2 Roy-Camille fracture.
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