Occipitoatlantal hypermobility
Wiesel, S.W.; Rothman, R.H.
Spine 4(3): 187-191
1979
ISSN/ISBN: 0362-2436 PMID: 472888 Document Number: 153350
Flexion-extension lateral roentgenograms from 20 normal volunteers were evaluated. The normal range of horizontal translation in flexion and extension as measured from the occiput basion to the odontoid tip was 1 mm or less. Of the 2 patients with excessive motion between the occiput and the atlas, 1 had an associated congenital C1-2 and C3-4 fusion; the other had congenital C2-3 fusion. Both presented with subjective complaints of extremity weakness with motion of the cervical spine and neck pain with occipital radiation. Relief in both patients was obtained by posterior fusion from the occiput to C2. A high cervical fusion may produce more stress at the atlanto-occipital articulation gradually causing ligaments stretching, resulting in hypermobility. Any patient with a congenital high cervical spine fusion should be followed very closely; and with any subjective complaints, flexion-extension roentgenograms should be obtained, with careful attention directed to the occipitoatlantal joint.