Region II: C1 ring and C1–C2 joint - Type C: Translation injury of the C1–C2 joint
Type C injuries are all injuries with atlantoaxial instability or displacement in any plane.
These injuries can be very unstable and may require operative management.
C1–C2 Rotatory subluxation
These are unique situations, which present in the pediatric age group after minor trauma or after throat inflammatory processes.
The transverse ligament is usually intact.
The treatment is conservative in acute cases with cervical traction and collar treatment. If closed reduction cannot be achieved, then open reduction and C1–C2 fusion would be indicated.
C1–C2 dislocations
C1–C2 dislocations may occur in traumatic accidents, but also with minor trauma, in congenital anomalies, or rheumatoid patients.
Axial CT images will show spinal canal narrowing due to the anterior dislocation.
The treatment is in general surgical with C1–C2 fusion.
