Unilateral C1–C2 vertical distraction injuries: Can we treat conservatively?

Unilateral or incomplete AAJ vertical distraction injuries lie on a spectrum of injury involving the craniocervical junction and more specifically the C1-C2 articulation. MRI is essential to evaluate the ligamentous stabilizers of the craniocervical junction prior to any treatment decisions, but in the absence of an unstable ligamentous injury, incomplete or unilateral vertical distraction injuries can be safely managed conservatively. This study is one of few to examine unilateral ligamentous injury between the atlas and axis of the spine. This study shows that in the absence of injury instability, these injuries can successfully be treated nonoperatively with successful patient outcomes.