{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:45:21Z","timestamp":1787755521895,"version":"build-2784847793"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JBJS Case Connector"],"abstract":"\n Case:<\/jats:title>\n A 35-year-old man was involved in a motor-vehicle collision and sustained multiple thoracoabdominal and extremity injuries. A high injury burden and a normal neurologic examination contributed to a delay in diagnosing a ligamentous, combined atlanto-occipital dissociation (AOD) and vertical atlantoaxial injury (AAI). Additional imaging revealed the combined injury, and the patient underwent an occipitocervical fusion.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n To our knowledge, this is the first case of a simultaneous traumatic AOD and AAI without fracture in a neurologically intact patient. Knowledge of reliable and easily applied radiographic relationships is important to expeditiously diagnose potentially lethal yet easily overlooked occipitocervical injuries.<\/jats:p>\n <\/jats:sec>","DOI":"10.2106\/jbjs.cc.18.00021","type":"journal-article","created":{"date-parts":[[2018,8,7]],"date-time":"2018-08-07T15:27:37Z","timestamp":1533655657000},"page":"e62-e62","source":"Crossref","is-referenced-by-count":10,"title":["Traumatic Atlanto-Occipital Dissociation and Atlantoaxial Instability: Concomitant Ligamentous Injuries without Neurologic Deficit"],"prefix":"10.2106","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6168-0175","authenticated-orcid":false,"given":"Daniel G.","family":"Tobert","sequence":"first","affiliation":[{"name":"Harvard Combined Orthopaedic Residency Program, Massachusetts General Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7881-5531","authenticated-orcid":false,"given":"Marco L.","family":"Ferrone","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2291-5944","authenticated-orcid":false,"given":"Gregory J.","family":"Czuczman","sequence":"additional","affiliation":[{"name":"Radiology Imaging Associates, Englewood, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,9]]},"reference":[{"issue":"19","key":"bib1-20230811","doi-asserted-by":"crossref","first-page":"2066","DOI":"10.1097\/BRS.0b013e31817e2cfc","article-title":"Occipitocervical vertical distraction injuries: anatomical biomechanical, and 3-Tesla magnetic resonance imaging investigation","volume":"33","author":"Y\u00fcksel","year":"2008","journal-title":"Spine (Phila Pa 1976)."},{"issue":"5","key":"bib2-20230811","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1016\/j.spinee.2013.01.023","article-title":"The utility and accuracy of computed tomography in the diagnosis of occipitocervical dissociation","volume":"13","author":"Gire","year":"2013","journal-title":"Spine J."},{"issue":"5","key":"bib3-20230811","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1227\/01.neu.0000303196.87672.78","article-title":"Atlanto-occipital dislocation\u2014part 2: the clinical use of (occipital) condyle-C1 interval, comparison with other diagnostic methods, and the manifestation, management, and outcome of atlanto-occipital dislocation in children","volume":"61","author":"Pang","year":"2007","journal-title":"Neurosurgery."},{"issue":"9","key":"bib4-20230811","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1097\/BRS.0b013e3181de4ec1","article-title":"Defining and detecting missed ligamentous injuries of the occipitocervical complex","volume":"36","author":"Chaput","year":"2011","journal-title":"Spine (Phila Pa 1976)."},{"issue":"2","key":"bib5-20230811","doi-asserted-by":"crossref","first-page":"248","DOI":"10.2106\/00004623-197961020-00014","article-title":"The pathological anatomy of fatal atlanto-occipital dislocations","volume":"61","author":"Bucholz","year":"1979","journal-title":"J Bone Joint Surg Am."},{"issue":"11","key":"bib6-20230811","doi-asserted-by":"crossref","first-page":"2385","DOI":"10.1016\/j.spinee.2015.07.003","article-title":"Traumatic atlantooccipital dislocation: comprehensive assessment of mortality, neurologic improvement, and patient-reported outcomes at a level 1 trauma center over 15 years","volume":"15","author":"Mendenhall","year":"2015","journal-title":"Spine J."},{"issue":"3","key":"bib7-20230811","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1097\/00000433-199009000-00003","article-title":"Atlanto-occipital disarticulation. 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