{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T02:25:00Z","timestamp":1793672700636,"version":"4.5.1"},"reference-count":80,"publisher":"Elsevier BV","issue":"12","license":[{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","thespinejournalonline.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Spine Journal"],"published-print":{"date-parts":[[2022,12]]},"DOI":"10.1016\/j.spinee.2022.08.008","type":"journal-article","created":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T01:00:46Z","timestamp":1661302846000},"page":"1944-1952","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":19,"title":["Craniocervical instability in patients with Ehlers-Danlos syndrome: controversies in diagnosis and management"],"prefix":"10.1016","volume":"22","author":[{"given":"Gordon","family":"Mao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5862-7063","authenticated-orcid":false,"given":"Srujan","family":"Kopparapu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8416-1300","authenticated-orcid":false,"given":"Yike","family":"Jin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1508-3449","authenticated-orcid":false,"given":"A. Daniel","family":"Davidar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1755-3974","authenticated-orcid":false,"given":"Andrew M.","family":"Hersh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2057-8419","authenticated-orcid":false,"given":"Carly","family":"Weber-Levine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5355-2683","authenticated-orcid":false,"given":"Nicholas","family":"Theodore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.spinee.2022.08.008_bib0001","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1007\/s00381-008-0606-8","article-title":"Anatomy and biomechanics of normal craniovertebral junction (a) and biomechanics of stabilization (b)","volume":"24","author":"Menezes","year":"2008","journal-title":"Child's Nerv Syst"},{"key":"10.1016\/j.spinee.2022.08.008_bib0002","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1007\/s13244-016-0530-5","article-title":"The craniocervical junction: embryology, anatomy, biomechanics and imaging in blunt trauma","volume":"8","author":"Offiah","year":"2017","journal-title":"Insights Imaging"},{"key":"10.1016\/j.spinee.2022.08.008_bib0003","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1148\/radiographics.14.2.8190952","article-title":"Craniovertebral junction: normal anatomy, craniometry, and congenital anomalies","volume":"14","author":"Smoker","year":"1994","journal-title":"Radiographics"},{"key":"10.1016\/j.spinee.2022.08.008_bib0004","doi-asserted-by":"crossref","first-page":"S225","DOI":"10.1016\/j.spinee.2006.09.001","article-title":"Anatomical, biomechanical, and practical considerations in posterior occipitocervical instrumentation","volume":"6","author":"Wolfla","year":"2006","journal-title":"Spine J"},{"key":"10.1016\/j.spinee.2022.08.008_bib0005","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1097\/00003086-197506000-00011","article-title":"Biomechanical analysis of clinical stability in the cervical spine","volume":"109","author":"White 3rd","year":"1975","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.spinee.2022.08.008_bib0006","doi-asserted-by":"crossref","first-page":"532","DOI":"10.3171\/2013.6.PEDS13271","article-title":"Letter to the editor: occipitocervical fusion","volume":"12","author":"Theodore","year":"2013","journal-title":"J Neurosurg Pediatr"},{"key":"10.1016\/j.spinee.2022.08.008_bib0007","first-page":"165","article-title":"International morquio a registry: clinical manifestation and natural course of morquio a disease","volume":"30","author":"Monta\u00f1o","year":"2007","journal-title":"J Inherit Metab Dis Off J Soc Study Inborn Errors Metab"},{"key":"10.1016\/j.spinee.2022.08.008_bib0008","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1097\/00007632-197905000-00001","article-title":"Occipitoatlantal hypermobility","volume":"4","author":"Wiesel","year":"1979","journal-title":"Spine (Phila Pa 1976)"},{"key":"10.1016\/j.spinee.2022.08.008_bib0009","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1002\/ajmg.c.31549","article-title":"Neurological and spinal manifestations of the ehlers\u2013danlos syndromes","volume":"175","author":"Henderson Sr","year":"2017","journal-title":"Am J Med Genet Part C Semin Med Genet"},{"key":"10.1016\/j.spinee.2022.08.008_bib0010","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1136\/ard.52.9.629","article-title":"Neuropathology of the brainstem and spinal cord in end stage rheumatoid arthritis: implications for treatment","volume":"52","author":"Henderson","year":"1993","journal-title":"Ann Rheum Dis"},{"key":"10.1016\/j.spinee.2022.08.008_bib0011","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1007\/s10143-018-01070-4","article-title":"Cervical medullary syndrome secondary to craniocervical instability and ventral brainstem compression in hereditary hypermobility connective tissue disorders: 5-year follow-up after craniocervical reduction, fusion, and stabilization","volume":"42","author":"Henderson","year":"2019","journal-title":"Neurosurg Rev"},{"key":"10.1016\/j.spinee.2022.08.008_bib0012","doi-asserted-by":"crossref","first-page":"432","DOI":"10.7861\/clinmedicine.14-4-432","article-title":"Ehlers\u2013Danlos syndrome\u2013a commonly misunderstood group of conditions","volume":"14","author":"Sobey","year":"2014","journal-title":"Clin Med (Northfield Il)"},{"key":"10.1016\/j.spinee.2022.08.008_bib0013","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1177\/1941738112452385","article-title":"Ehlers-danlos syndrome in orthopaedics: etiology, diagnosis, and treatment implications","volume":"4","author":"Shirley","year":"2012","journal-title":"Sports Health"},{"key":"10.1016\/j.spinee.2022.08.008_bib0014","doi-asserted-by":"crossref","first-page":"2989","DOI":"10.1002\/ajmg.a.36315","article-title":"Re-writing the natural history of pain and related symptoms in the joint hypermobility syndrome\/Ehlers\u2013Danlos syndrome, hypermobility type","volume":"161","author":"Castori","year":"2013","journal-title":"Am J Med Genet Part A"},{"key":"10.1016\/j.spinee.2022.08.008_bib0015","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1007\/s00381-008-0603-y","article-title":"Specific entities affecting the craniocervical region: down's syndrome. Child's","volume":"24","author":"Menezes","year":"2008","journal-title":"Nerv Syst"},{"key":"10.1016\/j.spinee.2022.08.008_bib0016","doi-asserted-by":"crossref","DOI":"10.1155\/2013\/764659","article-title":"Ehlers danlos syndrome: an unusual presentation you need to know about","author":"Karaa","year":"2013","journal-title":"Case Rep Pediatr"},{"key":"10.1016\/j.spinee.2022.08.008_bib0017","doi-asserted-by":"crossref","first-page":"233","DOI":"10.5435\/00124635-200604000-00005","article-title":"Nontraumatic upper cervical spine instability in children","volume":"14","author":"Wills","year":"2006","journal-title":"JAAOS-Journal Am Acad Orthop Surg"},{"key":"10.1016\/j.spinee.2022.08.008_bib0018","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1080\/02688697.2017.1386282","article-title":"Ehlers Danlos, complex Chiari and cranio-cervical fixation: how best should we treat patients with hypermobility?","volume":"31","author":"Brodbelt","year":"2017","journal-title":"Br J Neurosurg"},{"key":"10.1016\/j.spinee.2022.08.008_bib0019","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/j.injury.2007.09.018","article-title":"The use of dynamic CT surview for cervical spine clearance in comatose trauma patients: a pilot prospective study","volume":"39","author":"Anekstein","year":"2008","journal-title":"Injury"},{"key":"10.1016\/j.spinee.2022.08.008_bib0020","doi-asserted-by":"crossref","first-page":"341","DOI":"10.3171\/2010.11.SPINE09870","article-title":"The role of flexion and extension computed tomography with reconstruction in clearing the cervical spine in trauma patients: a pilot study","volume":"14","author":"Wadhwa","year":"2011","journal-title":"J Neurosurg Spine"},{"key":"10.1016\/j.spinee.2022.08.008_bib0021","doi-asserted-by":"crossref","first-page":"271","DOI":"10.5312\/wjo.v8.i3.271","article-title":"Role of dynamic computed tomography scans in patients with congenital craniovertebral junction malformations","volume":"8","author":"da Silva","year":"2017","journal-title":"World J Orthop"},{"key":"10.1016\/j.spinee.2022.08.008_bib0022","doi-asserted-by":"crossref","first-page":"30","DOI":"10.4103\/2152-7806.66461","article-title":"Deformative stress associated with an abnormal clivo-axial angle: a finite element analysis","volume":"1","author":"Henderson","year":"2010","journal-title":"Surg Neurol Int"},{"key":"10.1016\/j.spinee.2022.08.008_bib0023","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/BF01743100","article-title":"Craniocervical abnormalities","volume":"6","author":"Nagashima","year":"1983","journal-title":"Neurosurg Rev"},{"key":"10.1016\/j.spinee.2022.08.008_bib0024","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1007\/s10143-013-0471-0","article-title":"Angular craniometry in craniocervical junction malformation","volume":"36","author":"Botelho","year":"2013","journal-title":"Neurosurg Rev"},{"key":"10.1016\/j.spinee.2022.08.008_bib0025","doi-asserted-by":"crossref","first-page":"181","DOI":"10.2214\/ajr.151.1.181","article-title":"Rheumatoid arthritis of the cervical spine: surface-coil MR imaging","volume":"151","author":"Bundschuh","year":"1988","journal-title":"Am J Roentgenol"},{"key":"10.1016\/j.spinee.2022.08.008_bib0026","first-page":"69","article-title":"Radiology of asymptomatic craniovertebral anomalies and abnormalities","author":"Vangilder","year":"1987","journal-title":"Craniovertebral Junction Its Abnorm Mt Kisco, NY Futur Pub Co"},{"key":"10.1016\/j.spinee.2022.08.008_bib0027","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/s10143-017-0830-3","article-title":"Utility of the clivo-axial angle in assessing brainstem deformity: pilot study and literature review","volume":"41","author":"Henderson","year":"2018","journal-title":"Neurosurg Rev"},{"key":"10.1016\/j.spinee.2022.08.008_bib0028","series-title":"Proc. CSF Colloq","article-title":"Co-morbidities that complicate the treatment and outcomes of chiari malformation","author":"Batzdorf","year":"2014"},{"key":"10.1016\/j.spinee.2022.08.008_bib0029","unstructured":"Symposium 2nd International CSF Dynamics. Consensus statement. 2013. Available at: https:\/\/csfinfo.org\/files\/1613\/9665\/4797\/Final_Booklet_complete.pdf. Access date 5\/11\/2022."},{"key":"10.1016\/j.spinee.2022.08.008_bib0030","doi-asserted-by":"crossref","first-page":"301","DOI":"10.3171\/2011.9.JNS11386","article-title":"Craniovertebral junction abnormalities with hindbrain herniation and syringomyelia: regression of syringomyelia after removal of ventral craniovertebral junction compression","volume":"116","author":"Menezes","year":"2012","journal-title":"J Neurosurg"},{"key":"10.1016\/j.spinee.2022.08.008_bib0031","doi-asserted-by":"crossref","first-page":"881","DOI":"10.2214\/ajr.162.4.8141012","article-title":"Radiologic diagnosis of traumatic occipitovertebral dissociation: 1. Normal occipitovertebral relationships on lateral radiographs of supine subjects","volume":"162","author":"Harris Jr","year":"1994","journal-title":"AJR Am J Roentgenol"},{"key":"10.1016\/j.spinee.2022.08.008_bib0032","doi-asserted-by":"crossref","first-page":"113","DOI":"10.3171\/spi.2007.6.2.113","article-title":"Survivors of occipitoatlantal dislocation injuries: imaging and clinical correlates","volume":"6","author":"Horn","year":"2007","journal-title":"J Neurosurg Spine"},{"key":"10.1016\/j.spinee.2022.08.008_bib0033","series-title":"Clinical Biomechanics of the Spine","author":"White","year":"1990"},{"key":"10.1016\/j.spinee.2022.08.008_bib0034","doi-asserted-by":"crossref","first-page":"123","DOI":"10.4184\/asj.2016.10.1.123","article-title":"New radiographic index for occipito-cervical instability","volume":"10","author":"Park","year":"2016","journal-title":"Asian Spine J"},{"key":"10.1016\/j.spinee.2022.08.008_bib0035","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1097\/00006123-199903000-00050","article-title":"Ventral brain stem compression in pediatric and young adult patients with Chiari I malformations","volume":"44","author":"Grabb","year":"1999","journal-title":"Neurosurgery"},{"key":"10.1016\/j.spinee.2022.08.008_bib0036","doi-asserted-by":"crossref","first-page":"538","DOI":"10.3171\/2012.9.PEDS12110","article-title":"Neurological deterioration after foramen magnum decompression for Chiari malformation type I: old or new pathology?","volume":"10","author":"Klekamp","year":"2012","journal-title":"J Neurosurg Pediatr"},{"key":"10.1016\/j.spinee.2022.08.008_bib0037","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1097\/01.rct.0000238009.57307.26","article-title":"Dynamic magnetic resonance imaging evaluation of craniovertebral junction abnormalities","volume":"31","author":"Gupta","year":"2007","journal-title":"J Comput Assist Tomogr"},{"key":"10.1016\/j.spinee.2022.08.008_bib0038","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1097\/00004424-199808000-00004","article-title":"Dynamic changes of the spinal canal in patients with cervical spondylosis at flexion and extension using magnetic resonance imaging","volume":"33","author":"Muhle","year":"1998","journal-title":"Invest Radiol"},{"key":"10.1016\/j.spinee.2022.08.008_bib0039","doi-asserted-by":"crossref","first-page":"E1134","DOI":"10.1097\/BRS.0b013e3181f822c7","article-title":"Preoperative evaluation of the cervical spondylotic myelopathy with flexion-extension magnetic resonance imaging: about a prospective study of fifty patients","volume":"36","author":"Zhang","year":"2011","journal-title":"Spine (Phila Pa 1976)"},{"key":"10.1016\/j.spinee.2022.08.008_bib0040","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1111\/os.12137","article-title":"Kinetic magnetic resonance imaging analysis of spinal degeneration: a systematic review","volume":"6","author":"Lao","year":"2014","journal-title":"Orthop Surg"},{"key":"10.1016\/j.spinee.2022.08.008_bib0041","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1097\/00007611-200405000-00008","article-title":"Dynamic weight-bearing cervical magnetic resonance imaging: technical review and preliminary results","volume":"97","author":"Vitaz","year":"2004","journal-title":"South Med J"},{"key":"10.1016\/j.spinee.2022.08.008_bib0042","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1055\/s-0034-1375563","article-title":"Kinetic magnetic resonance imaging of the cervical spine: a review of the literature","volume":"4","author":"Lord","year":"2014","journal-title":"Glob Spine J"},{"key":"10.1016\/j.spinee.2022.08.008_bib0043","doi-asserted-by":"crossref","first-page":"601","DOI":"10.3171\/SPI-07\/12\/601","article-title":"Syndrome of occipitoatlantoaxial hypermobility, cranial settling, and chiari malformation type I in patients with hereditary disorders of connective tissue","volume":"7","author":"Milhorat","year":"2007","journal-title":"J Neurosurg Spine"},{"key":"10.1016\/j.spinee.2022.08.008_bib0044","first-page":"1","article-title":"Positional magnetic resonance imaging for people with Ehlers-Danlos syndrome or suspected craniovertebral or cervical spine abnormalities: an evidence-based analysis","volume":"15","author":"Ontario","year":"2015","journal-title":"Ont Health Technol Assess Ser"},{"key":"10.1016\/j.spinee.2022.08.008_bib0045","doi-asserted-by":"crossref","first-page":"1580","DOI":"10.1097\/00007632-199707150-00010","article-title":"Atlantoaxial fusion and retrodental pannus in rheumatoid arthritis","volume":"22","author":"Grob","year":"1997","journal-title":"Spine (Phila Pa 1976)"},{"key":"10.1016\/j.spinee.2022.08.008_bib0046","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/S0090-3019(01)00345-7","article-title":"Retro-odontoid soft tissue mass associated with atlantoaxial subluxation in an elderly patient: a case report","volume":"55","author":"Isono","year":"2001","journal-title":"Surg Neurol"},{"key":"10.1016\/j.spinee.2022.08.008_bib0047","doi-asserted-by":"crossref","first-page":"466","DOI":"10.3171\/jns.1990.73.3.0466","article-title":"Occipitocervical fusion for reduction of traumatic periodontoid hypertrophic cicatrix: case report","volume":"73","author":"Lansen","year":"1990","journal-title":"J Neurosurg"},{"key":"10.1016\/j.spinee.2022.08.008_bib0048","doi-asserted-by":"crossref","first-page":"1961","DOI":"10.1097\/00007632-199909150-00017","article-title":"Complete reduction of retro-odontoid soft tissue mass in os odontoideum following the posterior C1-C2 tranarticular screw fixation","volume":"24","author":"Jun","year":"1999","journal-title":"Spine (Phila Pa 1976)"},{"key":"10.1016\/j.spinee.2022.08.008_bib0049","first-page":"524","article-title":"Forestier's disease","volume":"85","author":"Goffin","year":"1996","journal-title":"J Neurosurg"},{"key":"10.1016\/j.spinee.2022.08.008_bib0050","doi-asserted-by":"crossref","first-page":"580","DOI":"10.3171\/jns.1983.58.4.0580","article-title":"Tophaceous gout producing spinal cord compression: case report","volume":"58","author":"Leaney","year":"1983","journal-title":"J Neurosurg"},{"key":"10.1016\/j.spinee.2022.08.008_bib0051","doi-asserted-by":"crossref","first-page":"190","DOI":"10.3171\/spi.2002.96.2.0190","article-title":"Forestier disease associated with a retroodontoid mass causing cervicomedullary compression","volume":"96","author":"Patel","year":"2002","journal-title":"J Neurosurg Spine"},{"key":"10.1016\/j.spinee.2022.08.008_bib0052","doi-asserted-by":"crossref","first-page":"803","DOI":"10.3171\/jns.1996.85.5.0803","article-title":"Periodontoid calcium pyrophosphate dihydrate deposition disease:\u201cpseudogout\u201d mass lesions of the craniocervical junction","volume":"85","author":"Z\u00fcnkeler","year":"1996","journal-title":"J Neurosurg"},{"key":"10.1016\/j.spinee.2022.08.008_bib0053","first-page":"2152","article-title":"Patients with type IV Ehlers-Danlos syndrome may be predisposed to atlantoaxial subluxation","volume":"22","author":"Halko","year":"1995","journal-title":"J Rheumatol"},{"key":"10.1016\/j.spinee.2022.08.008_bib0054","doi-asserted-by":"crossref","first-page":"2481","DOI":"10.1007\/s10067-020-05158-5","article-title":"Comment on \u201cquantitative measures of tissue mechanics to detect hypermobile ehlers-danlos syndrome and hypermobility syndrome disorders: a systematic review","volume":"39","author":"Grahame","year":"2020","journal-title":"Clin Rheumatol"},{"key":"10.1016\/j.spinee.2022.08.008_bib0055","doi-asserted-by":"crossref","first-page":"18","DOI":"10.3171\/2020.10.SPINE201765","article-title":"Abnormal spinal cord motion at the craniocervical junction in hypermobile Ehlers-Danlos patients","volume":"35","author":"Klinge","year":"2021","journal-title":"J Neurosurg Spine"},{"key":"10.1016\/j.spinee.2022.08.008_bib0056","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.spinee.2011.01.021","article-title":"Biomechanical analysis of occipitocervical stability afforded by three fixation techniques","volume":"11","author":"Helgeson","year":"2011","journal-title":"Spine J"},{"key":"10.1016\/j.spinee.2022.08.008_bib0057","doi-asserted-by":"crossref","first-page":"S44","DOI":"10.1016\/j.injury.2005.06.014","article-title":"Indications for surgery and stabilization techniques of the occipito-cervical junction","volume":"36","author":"Vaccaro","year":"2005","journal-title":"Injury"},{"key":"10.1016\/j.spinee.2022.08.008_bib0058","doi-asserted-by":"crossref","first-page":"287","DOI":"10.4103\/jcvjs.JCVJS_166_20","article-title":"Ehlers\u2013Danlos syndrome-associated craniocervical instability with cervicomedullary syndrome: comparing outcome of craniocervical fusion with occipital bone versus occipital condyle fixation","volume":"11","author":"Spiessberger","year":"2020","journal-title":"J Craniovertebr Junction Spine"},{"key":"10.1016\/j.spinee.2022.08.008_bib0059","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1002\/ajmg.c.31551","article-title":"Orthopaedic management of the Ehlers\u2013Danlos syndromes","volume":"175","author":"Ericson Jr","year":"2017","journal-title":"Am J Med Genet Part C Semin Med Genet"},{"key":"10.1016\/j.spinee.2022.08.008_bib0060","doi-asserted-by":"crossref","first-page":"573","DOI":"10.3171\/2012.2.PEDS11371","article-title":"Craniocervical fusions in children: a review","volume":"9","author":"Menezes","year":"2012","journal-title":"J Neurosurg Pediatr"},{"key":"10.1016\/j.spinee.2022.08.008_bib0061","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1227\/NEU.0000000000001340","article-title":"Occipitocervical fixation: a single surgeon's experience with 120 patients","volume":"79","author":"Martinez-del-Campo","year":"2016","journal-title":"Neurosurgery"},{"key":"10.1016\/j.spinee.2022.08.008_bib0062","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1007\/s00381-008-0607-7","article-title":"Fusions at the craniovertebral junction","volume":"24","author":"Ahmed","year":"2008","journal-title":"Child's Nerv Syst"},{"key":"10.1016\/j.spinee.2022.08.008_bib0063","doi-asserted-by":"crossref","first-page":"1396","DOI":"10.1227\/NEU.0b013e3181f1ec73","article-title":"A review of complications associated with craniocervical fusion surgery","volume":"67","author":"Lall","year":"2010","journal-title":"Neurosurgery"},{"key":"10.1016\/j.spinee.2022.08.008_bib0064","doi-asserted-by":"crossref","first-page":"8","DOI":"10.3171\/2014.11.SPINE14484","article-title":"Correction of clivoaxial angle deformity in the setting of suboccipital craniectomy: technical note","volume":"23","author":"Felbaum","year":"2015","journal-title":"J Neurosurg Spine SPI"},{"key":"10.1016\/j.spinee.2022.08.008_bib0065","doi-asserted-by":"crossref","first-page":"5","DOI":"10.3171\/2010.3.SPINE08143","article-title":"A systematic review of occipital cervical fusion: techniques and outcomes: a review","volume":"13","author":"Winegar","year":"2010","journal-title":"J Neurosurg Spine"},{"key":"10.1016\/j.spinee.2022.08.008_bib0066","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1016\/j.spinee.2006.08.010","article-title":"Atlantoaxial fusion: a biomechanical analysis of two C1\u2013C2 fusion techniques","volume":"7","author":"Claybrooks","year":"2007","journal-title":"Spine J"},{"key":"10.1016\/j.spinee.2022.08.008_bib0067","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1177\/2192568219877878","article-title":"Occipitocervical fixation: general considerations and surgical technique","volume":"10","author":"Joaquim","year":"2020","journal-title":"Glob Spine J"},{"key":"10.1016\/j.spinee.2022.08.008_bib0068","doi-asserted-by":"crossref","DOI":"10.1016\/j.wnsx.2019.100010","article-title":"A dual approach for the management of complex craniovertebral junction abnormalities: endoscopic endonasal odontoidectomy and posterior decompression with fusion","volume":"2","author":"Alalade","year":"2019","journal-title":"World Neurosurg X"},{"key":"10.1016\/j.spinee.2022.08.008_bib0069","doi-asserted-by":"crossref","DOI":"10.1227\/NEU.0b013e31827bf512","article-title":"Management of operative complications related to occipitocervical instrumentation","volume":"72","author":"Ahmed","year":"2013","journal-title":"Oper Neurosurg"},{"key":"10.1016\/j.spinee.2022.08.008_bib0070","doi-asserted-by":"crossref","unstructured":"Lohkamp LN, Marathe N, Fehlings MG. Craniocervical instability in ehlers-danlos syndrome\u2014a systematic review of diagnostic and surgical treatment criteria. Global Spine J 2022;2022:1\u201310. https:\/\/doi.org\/10.1177\/21925682211068520.","DOI":"10.1177\/21925682211068520"},{"key":"10.1016\/j.spinee.2022.08.008_bib0071","first-page":"319","article-title":"Rheumatoid arthritis of the cervical spine","volume":"1","author":"BLAND","year":"1974","journal-title":"J Rheumatol"},{"key":"10.1016\/j.spinee.2022.08.008_bib0072","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1136\/ard.55.12.901","article-title":"Development of a functional scoring system for rheumatoid arthritis patients with cervical myelopathy","volume":"55","author":"Casey","year":"1996","journal-title":"Ann Rheum Dis"},{"key":"10.1016\/j.spinee.2022.08.008_bib0073","doi-asserted-by":"crossref","first-page":"1282","DOI":"10.2106\/00004623-199309000-00004","article-title":"Rheumatoid arthritis of the cervical spine. a long-term analysis with predictors of paralysis and recovery","volume":"75","author":"Boden","year":"1993","journal-title":"J Bone Joint Surg Am"},{"key":"10.1016\/j.spinee.2022.08.008_bib0074","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1007\/BF02307410","article-title":"Occipito-cervical fixation in rheumatoid arthritis\u2014an analysis of surgical risk factors in 163 patients","volume":"135","author":"Zygmunt","year":"1995","journal-title":"Acta Neurochir (Wien)"},{"key":"10.1016\/j.spinee.2022.08.008_bib0075","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1097\/00003086-199909000-00007","article-title":"Occipitocervical fusion in patients with rheumatoid arthritis","volume":"366","author":"Grob","year":"1999","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.spinee.2022.08.008_bib0076","doi-asserted-by":"crossref","first-page":"342","DOI":"10.2106\/00004623-198163030-00003","article-title":"A prospective study of the progression of rheumatoid arthritis of the cervical spine","volume":"63","author":"Pellicci","year":"1981","journal-title":"JBJS"},{"key":"10.1016\/j.spinee.2022.08.008_bib0077","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1038\/nrrheum.2017.49","article-title":"Immunometabolism in early and late stages of rheumatoid arthritis","volume":"13","author":"Weyand","year":"2017","journal-title":"Nat Rev Rheumatol"},{"key":"10.1016\/j.spinee.2022.08.008_bib0078","doi-asserted-by":"crossref","first-page":"12","DOI":"10.21037\/acr-20-131","article-title":"Craniocervical instability associated with rheumatoid arthritis: a case report and brief review","volume":"5","author":"Chu","year":"2021","journal-title":"AME Case Reports"},{"key":"10.1016\/j.spinee.2022.08.008_bib0079","doi-asserted-by":"crossref","first-page":"e0034","DOI":"10.5041\/RMMJ.10261","article-title":"Ehlers-danlos syndrome-hypermobility type: a much neglected multisystemic disorder","volume":"7","author":"Gazit","year":"2016","journal-title":"Rambam Maimonides Med J"},{"key":"10.1016\/j.spinee.2022.08.008_bib0080","doi-asserted-by":"crossref","DOI":"10.1016\/j.wneu.2022.02.068","article-title":"Craniocervical stabilization after failed chiari decompression: a case series of a population with high prevalence of ehlers-danlos syndrome","volume":"161","author":"Zhao","year":"2022","journal-title":"World Neurosurg"}],"container-title":["The Spine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1529943022008749?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1529943022008749?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:37:21Z","timestamp":1761514641000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1529943022008749"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12]]},"references-count":80,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["S1529943022008749"],"URL":"https:\/\/doi.org\/10.1016\/j.spinee.2022.08.008","relation":{},"ISSN":["1529-9430"],"issn-type":[{"value":"1529-9430","type":"print"}],"subject":[],"published":{"date-parts":[[2022,12]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Craniocervical instability in patients with Ehlers-Danlos syndrome: controversies in diagnosis and management","name":"articletitle","label":"Article Title"},{"value":"The Spine Journal","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.spinee.2022.08.008","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2022 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}