Bilateral atlanto-occipital assimilation
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Bilateral atlanto-occipital assimilation. Congenital C2/3 fusion. Well-corticated calcification at anterior C4/5 disc space appear chronic and are degenerative in nature. No acute cervical spine fracture or malalignment demonstrated. Prevertebral soft tissues are within normal limits. Mild multilevel degenerative change with posterior disc bulges at C3/4, C4/5 and C5/6 indenting the thecal sac.
This case demonstrates partial atlanto-occipital assimilation, with the posterior arch of C1 not fully fused and still identifiable. Atlanto-occipital assimilation is often asymptomatic (as in this case) and represents a transitional vertebrae. There is also congenital C2/3 fusion, which is often associated.