Atlas (type 3b subtype 1) and axis (Anderson and D'Alonzo type 3, Roy-Camille type 2) fractures

Comminuted fracture of C1 involving the anterior arch, left lateral mass, and the posterior elements. Small fracture of the posterior arch of C1 is also noted. Resultant incongruent articulation of the lateral mass of C1/C2.

Posteriorly slanted oblique fracture of the odontoid process at the base, with posterior angulation of the dens and retropulsion. Moderate narrowing of the central canal at this level due to angulation of the odontoid process and suspected ligamentous thickening/ hematoma. Moderate degree of central spinal canal stenosis.

Prior surgical fusion at C5/C6, with suspected disc material at this level.

Jefferson multi-part fractures involving both the anterior and posterior C1 arches demonstrated with lateral displacement of the lateral mass of C1 relative to C2 (more on the right). Disrupted transverse atlantal ligament.

Mildly displaced type 3 oblique fracture of the dens with extension into the base and retrolisthesis of 5 mm.

Posterior displacement of the posterior longitudinal ligament demonstrated. No epidural hematoma. Severe narrowing of the upper cervical canal with compression of the upper cervical spinal cord with T2 hyperintense cord signal from the foramen magnum to C2 vertebral level for a length of 21 mm.

Prevertebral edema from base of skull to C4. Posterior para vertebral edema in the upper cervical region from hyperextension injury.