What factors or forces could cause displacement of my C6 vertebral fracture?

What Would Displace a C6 Fracture

A C6 fracture can be displaced by high-energy mechanisms including axial loading to the head, falls from height, high-speed motor vehicle crashes, or even minor trauma in patients with ankylosing spondylitis or other conditions causing spinal rigidity. 1, 2, 3

High-Energy Mechanisms of Displacement

The forces required to cause cervical spine fracture displacement are substantial in healthy bone:

• Axial loading to the head (such as diving injuries or objects falling on the head) represents a dangerous mechanism that can cause burst fractures with displacement 1
• Falls from elevation generate sufficient force to displace cervical fractures, particularly when landing on the head or in awkward positions 1
• High-speed motor vehicle crashes create the multi-directional forces necessary to cause fracture-dislocation patterns 1, 3
• Direct trauma with rotational components can cause complete fracture-dislocations, though neurologic sparing is possible even with severe displacement 4

Special Vulnerability: Ankylosing Spondylitis and Rigid Spine Conditions

Critically, patients with ankylosing spondylitis or other conditions causing spinal rigidity can sustain severe displaced cervical fractures from minor trauma that would not injure a normal spine:

• Minor falls (even from the first rung of a ladder) can cause transverse fractures through the C6 vertebral body with significant displacement in ankylosing spondylitis 2
• The rigid, fused spine acts as a long lever arm, concentrating forces at fracture sites and making even trivial trauma potentially catastrophic 2, 3
• These fractures are often transverse through the vertebral body and highly unstable 2, 3

Factors That Increase Risk of Displacement

Several factors make an existing C6 fracture more likely to displace:

• Age ≥65 years increases fracture instability risk 1
• Inadequate immobilization during transport or evaluation can allow displacement of initially non-displaced fractures 5
• Manipulation during airway management - studies show cervical spine motion occurs during intubation, with flexion/extension movements of 2.95° at C5-C6 even with cricoid pressure 5
• Posterior ligamentous complex disruption makes fractures inherently unstable and prone to displacement 5

Clinical Implications for Your C6 Fracture

If you have a C6 fracture, displacement risk depends on the fracture pattern and associated injuries:

• Lateral mass fractures can spontaneously reduce after initial displacement, making the injury appear less severe than it actually was 6
• Burst fractures with comminution are at higher risk for progressive displacement 5
• Any fracture with vertebral artery injury suggests high-energy trauma and potential instability 6

Avoid activities that could displace your fracture:

• No flexion, extension, or rotation of the neck 5
• Maintain proper immobilization as directed by your spine surgeon 5
• Avoid any trauma, including minor falls, as even low-energy mechanisms can cause displacement in an already-injured spine 2