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Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
In children up to 10 years old the maximum movement in the cervical spine with flexion and extension is at the C2-C3 level. There can be up to 5 mm of movement between C2 and C3 due to the ligamentous laxity at this level.
Use posterior cervical line which is drawn between the posterior arches of C1 to C3. With physiologic subluxation this line passes through or less than 1 mm anterior to the posterior cortex of C2. With a fracture of the arch of C2 this distance will be increased since C1 and the vertebral body of C2 will slip forward at the fracture site.
See References Chapter.
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