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Traumatic left lateral C2 epiphysiorhexis in a 3-year-old girl--a case report.

Preuß M et al. Traumatic Left Lateral C2 ... Eur J Pediatr Surg 2011; 21: 412–414 Introduction ▼ Spinal injuries in the occipito-cervical region are rare in children and, in most cases, are associated with high-speed deceleration trauma such as car accidents. Injuries predominantly occur at the C2 level as odontoid fractures, but cases of epiphysiolysis have been reported, too [ 1 – 6 ] . We report a case of a unilateral fracture of the left C2 base involving a torn left neurocentral synchondrosis. The axis develops from 4 ossifi cation centres [ 7 ] . The core centre for the vertebral body starts ossifi cation from the 5 th foetal month; this is followed by the centre of the dens axis which is formed from 2 parts and fuses between 7 th foetal month and birth; the 2 neural arch centres also start to fuse at around the 7 th foetal month. At birth, 3 synchondroses are left and these subsequently disappear between the age of 3 and 6 years. They are the growth plates between the dens and the core, also termed the “subdental synchondrosis”, and the bilateral growth plates between the core and the neural arches, the “neurocentral synchondroses” [ 8 ] . At the age of 3 years, these synchondroses are usually easily detected in CT scans.