Injury Stability

Unstable Injuries

  1. Hyperextension dislocation
  2. Bilateral interfacetal dislocation (hyperflexion injury)
  3. Flexion tear-drop fracture
  4. Extension tear-drop fracture
  5. Hangman's fracture
  6. Jefferson burst fracture
  7. Hyperextension fracture-dislocation

Stable Injuries

  1. Anterior subluxation
  2. Unilateral interfacetal dislocation
  3. Simple wedge fracture
  4. Burst fracture
  5. Fracture of posterior arch of C1
  6. Pillar fracture
  7. Clay shoveler's fracture

Stability Ranking

MOST unstable  LEAST unstable

  1. Rupture of the transverse ligament of the atlas
  2. Fracture of the dens (odontoid fracture)
  3. Flexion teardrop fracture (burst fracture with posterior ligamentous disruption)
  4. Bilateral facet dislocation
  5. Burst fracture without posterior ligamentous disruption
  6. Hyperextension fracture dislocation
  7. Hangman fracture
  8. Extension teardrop (stable in flexion)
  9. Jefferson fracture (burst fracture of the ring of C1)
  10. Unilateral facet dislocation
  11. Anterior subluxation
  12. Simple wedge compression fracture 
    ( without posterior disruption)
  13. Pillar fracture
  14. Fracture of the posterior arch of C1
  15. Spinous process fracture (clay shoveler fracture)