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This extends to the right transverse foramen (subsequent CTA did not demonstrate a vascular injury). Acute fracture of C2 as described which appears unstable involving the base of the dens, body and bilateral lateral masses.Many of the stable extension type I and II fractures can be treated with external immobilization, whereas the predominant flexion type IIa and III fractures require surgical stabilization. No evidence of acute facet joint widening or subluxation, although note that disruption of the joints can be difficult to completely exclude on CT. Hangman’s fractures are the second most common fracture pattern of the C2 vertebrae following odontoid fractures. Another classification system is the Roy-Camille classification, which aids more in the management of odontoid fractures. Multilevel degenerative changes of the cervical spine elsewhere (more prominent at C5/C6 and atlantodental articulation) with no further acute fracture identified. The Anderson and D'Alonzo classification is the most commonly used classification of fractures of the odontoid process of C2. Diagnosis can be made with standard lateral and open-mouth odontoid radiographs. Minimally displaced fracture of right C7 transverse process. Odontoid Fractures are relatively common fractures of the C2 (axis) dens that can be seen in low energy falls in elderly patients and high energy traumatic injuries in younger patients. Acute fracture through the right C6 transverse process anteriorly. It appears corticated without an obvious donor site. Linear sclerotic line through C1 left transverse process tip is of uncertain chronicity.ħ mm linear bony focus lateral to C6 is of uncertain chronicity. No obvious epidural thickening demonstrated on CT. Mild prominence of prevertebral soft tissues at this level and measures up to 5 mm AP, which remains within normal limits. C2 left lateral mass lateral cortex sits 3 mm lateral to C1 lateral mass. Fracture line separation with cortical steps of up to 3 mm (anterior displacement of the dens with respect to C2 body). Odontoid fractures represent the most common fractures involving C2 and the most common cervical spine fractures in patients older than 65 years. Acute oblique fracture through the base of C2 dens extending to the body and bilateral lateral masses as well as the right transverse foramen.