These injuries are unstable. They can be easily reduced with halo traction and extension. A halo vest does not always maintain the reduction. However, some residual displacement is compatible with the satisfactory results and those with minimal displacement can be treated without reduction. Why is that? Because the osteocytes will jump across the small posterior arch fracture gap and heal it. Also, since the disc is disrupted, approximately 70% of the Type II injuries will go on and have a spontaneous anterior fusion.

On some Type II injuries there may be a non-union posteriorly but you get a solid ankylosis anteriorly from the disruption of the disc (which again happens about 70% of the time). In a very unstable situation, you can do one of two things. When I wrote that article, we originally placed them in traction for six weeks.