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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).
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).
The distances between the dens and surrounding structures are also key features that can suggest the diagnosis, with the normal distance between the dens and basion (i.e., dens–basion interval; BDI) measuring less than 9 mm on CT, and the distance between the atlas and dens (i.e., atlas–dens interval; ADI) measuring less than 3 mm on CT, although this can be increased in cases of ...
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]
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]
Atlanto-axial joint instability can cause symptoms including vertigo and sudden death. [ 45 ] Atypical Cogan's syndrome may be associated with rheumoatoid arthritis.