Traumatic spondylolisthesis of C2 on C3 due to fracture if bilateral pars interarticularis
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What is the mechanism of injury?
Hyperextension injury due to rapid deceleration
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How do you classify hangman fractures? What is injured at each stage?
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Levine and Edwards
1 = translation < 3mm [UNDISPLACED - C2/C3 disc, ALL, PLL all intact]
2 = > 3mm / angulation < 11Β° [PLL torn]
2a = Severe angulation > 11Β° [ALL, PLL and Disc TORN]
3 = + facet dislocation [Very unstable]
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Typical vs Atypical
Atypical - involve vertebral body with a coronally oriented fracture line
Typical = does not involve VB
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How does typical vs atypical fractures affect presentation?
John starr et al. 1993
Atypical fractures more frequently accompanied by paralysis and neurology as the anterior elements being still fixed with the posterior elements translate backwards