Background Radiological evaluation is very important in spinal trauma patients during sport activities, specially in cases with atlas fractures.

Aim Aim of this study was to analyze the radiological evaluation and the role of X-ray, CT and MRI findings in 12 young patients with atlas fractures during sport activities (amateur and professional).

Material and Methods During a 12 year period (2000–2012) we analyzed 12 patients with atlas fractures during sport activities (amateur and professional). Ten male, two female, mean age 25, range from 16 to 30 years.

Results All of them 12,100% had admission X-rays and CT-scan that confirmed the presence of an atlas fracture. Ten patients,had also MRI-scan (group 1), two patients, only X-rays and CT-scan (group 2). We analyzed also the type of sport activity, amateur (group A, 6 patients 50%), professional (group B, 6 patients, 50 %), then the timing of injury, recent trauma (group I, 11 patients) and chronic trauma, more than seven days after the initial injury (group II, 1 patient). Two Jefferson burst fractures, four bilateral posterior arch fracture, one comminuted lateral mass fractures, one linear lateral mass fractures, one unilateral ring fracture, one asymmetric anterior and posterior arch fractures, two bilateral anterior arch fracture. Six patients were treated with Halo-Vest and Six Patients with Philadelphia Collar The average follow up was 18 months.

Conclusions Further studies were warranted but the combination of CT and MRI is is very useful for the evaluation and for the therapeutic approach of spinal trauma patients, specially in cases with atlas fractures. The long term stability seems to have good results.