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Atlanto-occipital dislocation, orthopedic decapitation, or internal decapitation describes ligamentous separation of the spinal column from the skull base. It is possible for a human to survive such an injury; however, 70% of cases result in immediate death .
Atlantoaxial instability is a common asymptomatic finding in rheumatoid arthritis patients. [3] However, it can lead to cervical myelopathy. [4] Patients with atlantoaxial instability can experience neck pain and headaches in the back of the head (occipital headaches).
Craniocervical instability is more common in people with a connective tissue disease, including Ehlers-Danlos syndromes, [1] osteogenesis imperfecta, and rheumatoid arthritis. [2] It is frequently co-morbid with atlanto-axial joint instability, Chiari malformation, [3] or tethered spinal cord syndrome.
The median atlanto-axial joint is sometimes considered a triple joint: [3] one between the posterior surface of the anterior arch of atlas and the front of the odontoid process; one between the anterior surface of the ligament and the back of the odontoid process; The lateral atlantoaxial joint involves the lateral mass of atlas and axis. [4]
The atlanto-occipital joint may be dislocated, especially from violent accidents such as traffic collisions. [1] This may be diagnosed using CT scans or magnetic resonance imaging of the head and neck. [1] Surgery may be used to fix the joint and any associated bone fractures. [1] Neck movement may be reduced long after this injury. [1]
"Z-thumb" or "Z-deformity" consists of hyperextension of the interphalangeal joint, fixed flexion and subluxation of the metacarpophalangeal joint and gives a "Z" appearance to the thumb. [16]: 1098 The hammer toe deformity may be seen. In the worst case, joints are known as arthritis mutilans due to the mutilating nature of the deformities. [20]
Grisel's syndrome is a non-traumatic subluxation of the atlanto-axial joint caused by inflammation of the adjacent tissues. This is a rare disease that usually affects children. Progressive throat and neck pain and neck stiffness can be followed by neurologic symptoms such as pain or numbness radiating to arms (radiculopathies).
The anterior longitudinal ligament extends superoinferiorly between the basiocciput of the skull and the anterior tubercle of the atlas (cervical certebra C1) superiorly, and the superior part of the sacrum inferiorly; [1] inferiorly, it ends at the sacral promontory. [2]