![]() ![]() Together C1 and C2 create the joint for side-to-side and up-and-down movement of the head. The odontoid process is the pivot for the C1 vertebra, which carries the cranium (head). The dens is the size of your small finger tip, and it sticks up from the front of the C2 vertebra and fits into a groove in the C1 vertebra ( Fig. The joint between C1 and C2 is unique in that it allows more movement than the other spinal joints. The blood supply to C2 is from branches of the internal carotid artery (a main artery in your neck) and vertebral (spine) artery with limited blood supply in a portion of the odontoid, also known as a watershed area. At maturity, the C2 vertebra consists of the odontoid process and the body. The second cervical vertebrae, also known as C2 or the axis, in the spine develops from a fusion process by the age of 12. Overall, odontoid fractures are the most common fracture of the C2 vertebra and can account for up to 15% of all cervical spine (neck) fractures. Sometimes these fractures are missed or left untreated, and they can be associated with increased morbidity (disease) in older patients. These fractures can alter the biomechanics (movement) of the cervical spine leading to pain, neurologic problems (numbness in the back, legs, and arms), and decreased stability. In young people, the injury typically happens during a high-trauma event, such as a motor vehicle accident, but for older patients, it can occur during low-energy trauma, such as a fall. Odontoid fractures can happen at any age, but the injury occurs most often in adolescents or older patients. The odontoid process is a unique peg-like bony structure of the C2 (second cervical) vertebra in the neck that physicians sometimes refer to as the dens ( Fig.
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