There are levels of restricted motion (hyposegmentation anomalies, operative fusions or acquired autofusions)

There are abnormal developmental anomalies affecting the C1 ring, C2 pars, and the dens

There is evidence of chronic arthropathy disorders affecting the spinal canal width (PLL traction spurs, OPLL, DISH, CPPD)

There is evidence of underlying inflammatory arthropathy possibly increasing or decreasing spine mobility (JRA, RA, psoriatic arthritis, etc.)

There is underlying bone pathology not related to trauma, but which could have a pathologic fracture

There is abnormal widening of dens tip to basion distance (or avulsion fracture of the clival tip) indicating apical ligament disruption

There is abnormal malalignment of the cervical canal with the foramen magnum

There is an abnormal X-lines indicating the dens is abnormally displaced

There is abnormal widening of the atlanto-axial distance indicating transverse ligament disruption

There is lilting of dens relative to C2 and/or avulsion fracture off the C1 ring indicating alar ligament disruption

There is widening of one or both occipital condyles to C1-lateral mass joint space widths indicating occip-cervical injury (2x average width = ligamentous injury)

There is widening of the width of C1-2 facet spaces indicating capsular injury (2x average width = ligamentous injury)

There is widening of the width of one or more uncovertebral joints indicating disc injury

There is widening of the width of C2-3 facet spaces consistent with facet capsular injury (2x average=injury)

There is fracture of either occipital condyles; include assessment of an occipital bone fracture extending into the condyle

There is a fracture of the C1 ring, or there is bilateral translational offset of the lateral masses of C1 relative to C2 (in AP plane) also consistent with a C1 ring fracture (or Jefferson's Fx) even if the fracture line is not discernible

There is fracture of the dens (3 types)

There is abnormal cortical rim fracture or medullary buckle or compression in the C2 body indicating fracture, especially at subdental synchondrosis

There is compressive buckle or fracture of the anterior vertebral body beginning at the fulcrum

There is compressive fracture of one side of the vertebral body indicating a lateroflexion vector

There is widening of posterior disc space width (PLL tear)

There is a posterior vertebral body corner avulsion fracture (Sharpey fiber insertion site)

There is malalignment & widening of the facet joint(s) 

There is fracture(s) of the articular processes

There is widening of the interlaminar & interspinous distances (2x average width = ligamentous injury)

There if compressive buckle or fracture of the posterior vertebral arch or pedicle(s) beginning at the fulcrum

There is displacement of bone fragments into the spinal canal or foramen transversarium

There is a compressive articular body fracture(s) (compression or burst)

There is malalignment of the facet joint(s) surfaces

There is widening of anterior disc space width (ALL tear)

There is a anterior vertebral body corner avulsion fracture (Sharpey fiber insertion site)

There is narrowing of the interlaminar & interspinous distances

There is evidence of a vertebral body spiral fracture consistent with a rotary injury

There is significant change in the degree of spine rotation at one motion segment based on the position of the articular pillars

There is significant change in the degree of spine rotation at one motion segment based on the width of the "interlaminar clear zone"

There is increased width of one or more unilateral uncovertebral joints to suggest a rotary discal injury

There is unilateral articular pillar injury on the same side as the widened uncovertebral joint

There is compression injury to the vertebral bodies with buckling, comminuted fractures or actually burst fractures

There is compression injury to the central portion of one or more vertebral end-plates

There is compressive hyperdensity in the medullary trabecular bone

There is compression on one side of one or more vertebral bodies indicating a lateroflexion mechanism

There is a single level transsection injury to the spine causing a combination of fractures, disc,/articular capsular ligament tears

There is underlying spinal fusion predisposing to shear injuries (i.e. ankylosing spondylitis, JRA, long segment spinal operative fusion)

There abnormal translational spinal alignment (anterolisthesis, posterolisthesis, or lateral listhesis)

There is focal spinal angulation (focal kyphosis-gibbus deformity)

There are injuries at more than one level

There is evidence of injury vectors with more than one mechanism

The columns of stability exceed more than one, indicating the spine is potentially unstable

Bone fragments are retropulsed into one or more neural foramina, indicating the nerve root or nerve root sleeve may be at risk

Bone and/or disc fragments are retropulsed into the spinal canal, indicating the spinal cord is at risk

Bone and/or disc fragments are retropulsed into the foramen transversaria raising the risk of vertebral arterial injury

There is swelling in the carotid sheath raising the risk of cartoid arterial injury

No other significant additional imaging findings are present.