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Craniocervical instability (CCI) is a medical condition characterized by excessive movement of the vertebra at the atlanto-occipital joint and the atlanto-axial joint located between the skull and the top two vertebra, known as C1 and C2.
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).
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]
Excessive laxity of the posterior transverse ligament can lead to atlantoaxial instability, a common complication in patients with Down Syndrome and Ehlers–Danlos syndrome. Laxity has also been hypothesized as the cause of degenerative hypertrophy and mechanical atlantoaxial stress. [3]
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).
Deformities of the spine, such as scoliosis (curvature of the spine), kyphosis (a thoracic hump), tethered spinal cord syndrome, craniocervical instability (CCI), and atlantoaxial instability may also be present. [48] [49] Osteoporosis and osteopenia are also associated with EDS and symptomatic joint hypermobility [50] [51]
The cruciate ligament of the atlas (cruciform ligament) is a cross-shaped (thus the name) ligament in the neck forming part of the atlanto-axial joint. It consists of the transverse ligament of atlas, a superior longitudinal band, and an inferior longitudinal band. The cruciate ligament of the atlas prevents abnormal movement of the atlanto ...
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]