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 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 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 and/or facet surface offset 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 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 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 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)

The articular process fracture are displaced into foramen transversarium; r/o vertebral artery injury

There is no posterior arch compressive fractures (i.e. lamina, pedicle, or spinous processes

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

There is malalignment of the facet joint(s) surfaces associated with the articular body compression fracture nor are there any bone fragments displaced into either the spinal canal or neural foramina

There is abnormal reduced interlaminar/interspinous distances or overlaping of the spinous processes.

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

There is a anterior vertebral body corner avulsion fracture (Sharpey fiber insertion site bone avulsion with potential ALL tear)

There is an abnormal interlaminar and/or interspinous distances suggesting ligamentous injury.

There is a spiral or oblique fracture of either the dens alone (type 2 dens fracture) or the dens plus the C2 vertebral body (type 3 dens fracture), which would suggest injury on a rotational basis rather the a hyperextension mechanism.

There is a spiral type of oblique vertebral body fracture, which may extend into the adjacent pedicle for cervical vertebral bodies C3 and below. Nor is there evidence of long axis splinter fracture of any lamina

There is unilateral capsular injury for the condylar C1/C2 joint space or the C1-2 joint space

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

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

There is a combination of a 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/crush 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 or just one of the articular pillars 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 abnormal single motion segment rotational subluxation, usually related to a unilateral articular pillar fracture with rotary offset and possibly perched or locked facets

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

There is evidence of injury vectors with more than one mechanism

There are injuries at more than one level

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 imaging findings are present.