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In season 3, episode 18 of the TV show 9-1-1 a teenage boy is treated for this injury after a train derailment. In episode 1 of season 9 of Chicago Med named Row Row Row Your Boat on a Rocky Sea , a 10 year old boy was treated for this injury after a car accident and fully recovered.
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 .
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]
A widening of the atlanto-axial joint, as measured between the posterior surface of the anterior arch of atlas and the front of the odontoid process, indicates an injury to the transverse atlantal ligament. [6] Normally, this atlanto-dental distance is less than 2 mm, sometimes a maximum of 3 mm is accepted in men and 2.5 mm in women. [6]
Inferiorly, it becomes continuous with the anterior sacrococcygeal ligament. [3] Superiorly, between the skull and atlas, the ligament is continuous laterally with the anterior atlantooccipital membrane. [4] The ligament is thick and slightly more narrow over the vertebral bodies and thinner but slightly wider over the intervertebral discs. [5]
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 ...
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 ]