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Cervical spinal column anatomically can be divided two part as upper and lower cervical spine. Upper cervical spine consists of the foramen magnum, paired occipital condyles, atlas and axis. C2 is the largest structure with its unique shape and function in this segment. The pars interarticularis and the pedicle are differently located in axis in comparison with other vertebrae. These two parts can be confused in the axis because of their unique anatomical localization. The pedicle of axis is the portion beneath the superior facet and anteromedial to the transverse foramen. In the other hand, the pars interarticularis or isthmus of axis is the narrower portion between the superior and inferior articulating facets. Fracture located at the pedicle of axis is extremely rare. The publications in this subject are still at the case presentation level. The presumed mechanism of injury is axial compression occurring in association with an asymmetrical lateral or rotatory component of the atlas on axis. Computerized tomography images with bone window and three-dimensional reconstruction of images of axis are the gold standard in the neuroradiological imaging of fracture. There is no specific clinical symptom and finding in the clinical diagnosing of the pedicle fracture. The neck pain may probably be present and the only symptom in the patient with unilateral pedicle fracture of axis. In the management of axis pedicle fracture, it is important that the patient’s age, presence of neurological deficit, additional fracture, ligament damage, and instability of the fracture. Isolated single-sided pedicle fractures are usually fractured in the form of unfragmented fissures. Such kinds of fractures are stabile fractures of C2. There is no need for surgical treatment in such patients.
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