C1 Atlas
Anterior arc alone : conservative
Posterior arc alone : operative
combined : x+y > 7mm = fracture of both arcs = Jefferson fracture : conservative or operative
C1/C2 instability
Atlanto axial instability
rupture of ligament transversum atlantis
C2 Dens
Typ I : spike : cons or op
Typ II : base of dens : operative
Typ III ; below base : cons (seldom operative)
Type A
compression
Conservative unless compression
Type B
Distraction
Operative
Type C
Rotation
Operative