Rule of Spence

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The "Rule of Spence" states that if the overhang of the combined C1 lateral masses relative to C2 is greater than or equal to 6.9 mm, the Ligamentum transversum is likely ruptured and the fracture should be considered unstable1. This displacement can be readily assessed on an anteroposterior radiograph of the cervical spine.

Figure

Rule of Spence
Schematic depiction of the Rule of Spence.

References

    1. SPENCE JR, KENNETH F., SCOTT DECKER, and KENNETH W. SELL. "Bursting atlantal fracture associated with rupture of the transverse ligament." JBJS 52.3 (1970): 543-549. ↩ ↩

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