Odontoid fractures result from an interaction between the load magnitude and bone quality. This shows bimodal distribution with peaks among early adults and the elderly population. The axis (C2) is the most common vertebra to be involved in cervical spine injuries, and odontoid fractures account for 50% of all C2 fractures. Odontoid fractures account for 20% of cervical spine fractures in the adult population and are the most common fracture subtype in geriatric patients (≥ 65 years). If the cervical spine is excessively flexed, then the transverse ligament can transmit the excessive anterior forces to the odontoid process and cause an odontoid fracture. The transverse ligament runs dorsal to (behind) the odontoid process and attaches to the lateral mass of C1 on either side. The odontoid fracture can also occur with hyperflexion of the cervical spine. The most common mechanism of injury is a hyperextension of the cervical spine, pushing the head and C1 vertebrae backward. If the energy mechanism and resulting force are high enough (or the patient's bone density is compromised secondary to osteopenia/osteoporosis), the odontoid will fracture with varying displacement and degrees of comminution. In the elderly population, the trauma can occur after lower energy impacts such as falls from a standing position. In younger patients, they are typically the result of high-energy trauma, which occurs as a result of a motor vehicle or diving accident. Odontoid fractures occur as a result of trauma to the cervical spine. Fracture of the odontoid process is classified into one of three types: type I, type II, or type III fractures, depending on the location and morphology of the fracture. The first cervical vertebrae (atlas) rotates around the odontoid process to provide the largest single component of lateral rotation of the cervical spine. The odontoid process, or dens, is a superior projecting bony element from the second cervical vertebrae (C2, or the axis). Discuss the importance of interprofessional team strategies for improving care coordination and communication to aid in prompt diagnosis of C2 odontoid fracture and improving outcomes in patients diagnosed with the condition.Summarize the treatment and management strategies available for C2 odontoid fractures based on the specific fracture type.Discuss the components of proper evaluation and assessment of a patient presenting with a potential odontoid process fracture, including any indicated imaging studies.Describe the unique vertebral anatomy of the second cervical vertebra (axis), including the odontoid process.This activity reviews the etiology, presentation, evaluation, and management of fractures of the C2 dens and reviews the role of the interprofessional team in evaluating, diagnosing, and managing the condition. The most common mechanism of injury is a hyperextension of the cervical spine, pushing the head and C1 vertebrae backward. Fracture of the odontoid process is classified into one of three types, which are type I, type II, or type III fractures, depending on the location and morphology of the fracture.
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