FIGURE 112.13 Effects of backboard on cervical spine position in a 6-month-old child with a hangman’s fracture (traumatic spondylolisthesis of posterior elements of C2) indicated by thin arrow A: Large occiput contributes to anterior subluxation (thick arrow ) of unstable cervical spine B: The same child on backboard with occipital recess Anterior subluxation is decreased (Reprinted with permission from Herzenberg J, Hensinger R, Dedrick D, et al Emergency transport and positioning of young children who have an injury of the cervical spine: the standard backboard may be hazardous J Bone Joint Surg Am 1989;71-A:18 Copyright © 1989 The Journal of Bone and Joint Surgery, Inc.)