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									Atlantooccipital dislocation (C0/C1) · Spinal column injuries                                                       H 07

 What is an atlantooccipital dislocation (C0/C1)

                                                                                                                           Spine Surgery Information Portal · Prof. Dr. Jürgen Harms · www.harms-spinesurgery.com
 An atlantooccipital dislocation is a severe injury of the upper cervical spine with a dislocation of the joint portions
 between the occipital bone and the 1st cervical vertebra. It occurs only rarely.

 • Upper cervical spine, C0-C2, from the rear

                                           · Occipital bone, (C0), (os occipitale)
                                           · Atlantooccipital joint (C0/C1), with joint capsule

                                           · Atlantooccipital joint (C0/C1), Joint capsule removed

                                           · Atlas (C1)

                                           · Axis (C2)

 What types of this injury are there?

 The following dislocation types are distinguished according to the direction of dislocation of the condyle masses
 of the occipital bone in relation to the 1st cervical vertebra:

 · Type I with dislocation toward the front (ventral)
 · Type II with dislocation toward the back (dorsal)
 · Type III with axial distraction of the atlantooccipital joints
 · Type IV with dislocation to the side (lateral)

 What are the symptoms?

 · Pronounced soft tissue swelling neck and head
 · Cranial nerve VI - XII failure
 · Symptoms of pinched brain stem, up to and including paralysis of respiratory and circulatory centers
   (gasping respiration, cardiac dysrhythmias)
 ·	This	injury	is	frequently	fatal	at	the	site	of	the	accident.
 · Patients who survive the injury often exhibit permanent neurological symptoms, up to and including tetraplegia
   (paraplegia in which arms and legs are affected)

 How is this injury treated?

  Following primary survival of this severe injury, the following surgical options are open:
  · Transoral C0/C1 fusion
  · Dorsal C0/C1 fusion
  · C0/C1/C2 fusion as needed

            Prof. Dr. med. Jürgen Harms · Klinikum Karlsbad-Langensteinbach · Guttmannstraße 1 · 76307 Karlsbad
                                   © www.harms-spinesurgery.com 2007. All rights reserved.

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