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Levine and Edwards Classification (based on mechanism of injury)
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| Type I |
- < 3mm horizontal displacement
- No angulation
- C2/3 disc remains intact
- stable fx pattern
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- Rigid cervical collar 4-6 weeks
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| Type II |
- > 3mm of horizontal displacement
- Significant angulation
- Vertical fracture line
- C2/3 disc and PLL are disrupted
- unstable fracture pattern
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- If < 5mm displacement than reduction with traction then halo immobilization for 6-12 weeks.
- If > 5mm displacement consider surgery or prolonged traction.
- Usually heal despite displacement (autofuse C2 on C3).
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| Type IIA |
- No horizontal displacement
- Horizontal fracture line
- Significant angulation
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- Avoid Traction in Type IIA.
- Reduction with hyperextension then halo immobilization for 6-12 weeks.
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| Type III |
- Type I fracture with associated bilateral C2-3 facet dislocation
- Rare injury pattern
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- Surgical reduction of facet dislocation followed by stabilization required.
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