Atlanto-occipital dissociation injuries

Atlanto-occipital dissociation injuries are severe and include both atlanto-occipital dislocations and atlanto-occipital subluxations.

The tectorial membrane and alar ligaments provide most of the stability to the atlanto-occipital joint, and injury to these ligaments results in instability due to low inherent osseous stability 3.

The key to the diagnosis, in addition to visualizing gross disruption of the normal alignment of the atlanto-occipital joint, hinges on using a number of lines on the lateral horizontal shoot-through cervical spine film 1:

For pediatric patients the condyle-C1 interval (CCI) has been shown to provide the highest diagnostic accuracy 4.

Article information

rID: 23151
Synonyms or Alternate Spellings:
  • Atlanto-occipital dissociation (AOD)
  • Atlanto-occipital dislocations
  • Atlanto-occipital subluxations
  • Atlanto-occipital dissociation

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Cases and figures

  • Case 1
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  • Case 2
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  • Case 3: widened basion-dens interval
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  • Case 4
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  • Case 5
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  • Case 6: base of skull lines
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  • Case 7
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  • Case 8: with basilar artery transection
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