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The most common mechanism of injury is high-speed motor vehicle accidents. The injury is more likely in children due to the large size of their heads relative to their bodies, and more horizontal orientation of the occipital condyles. It represents <1% of all cervical spine injuries. [1] Several subtypes of atlanto-occipital dislocation are known.
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]
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 .
Surgery may be used to fix the joint and any associated bone fractures. [1] Neck movement may be reduced long after this injury. [1] Such injuries may also lead to hypermobility, which may be diagnosed with radiographs. [2] This is especially true if traction is used during treatment. [2]
Instability of the cervical spine can cause endangerment of patients and their neurological integrity. [28] Correction and decompression cervical spinal surgeries significantly increase quality of life and reduce symptoms. Post-surgery, 93 to 100 percent of patients report reduced cervicocranial syndrome symptoms such as neck pain. [29] [30]
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]
Anterior shoulder dislocation is the most common type of shoulder dislocation, accounting for at least 90% of shoulder dislocations. [5] [36] Anterior shoulder dislocations have a recurrence rate around 39%, with younger age at initial dislocation, male sex, and joint hyperlaxity being risk factors for increased recurrence. [37]