Atlanto-occipital dissociation injuries

Atlanto-occipital dissociation injuries are severe and include both atlanto-occipital dislocations and atlanto-occipital subluxations.

Pathology

The tectorial membrane and alar ligaments provide most of the stability to the atlanto-occipital joint, and injury to these ligaments results in instability due to low inherent osseous stability .

Radiographic features

The key to the diagnosis, in addition to visualizing gross disruption of the normal alignment of the atlanto-occipital joint, hinges on using a number of lines on the lateral horizontal shoot-through cervical spine film :

CT

For pediatric patients the condyle-C1 interval (CCI) has been shown to provide the highest diagnostic accuracy.

Differential diagnosis

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