{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:25:10Z","timestamp":1761823510299},"reference-count":15,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2013,2]]},"abstract":"<jats:p>Atlantooccipital dislocation (AOD) is a rare and often fatal injury. In cases of survival, residual deficits are severe and often include cranial nerve palsy, quadriplegia, or respiratory issues. Occipitalization is defined as partial or complete congenital fusion of the occiput to the atlas and is exceptionally rare.<\/jats:p>\n<jats:p>The authors present a rare case of AOD superimposed on a congenital occipitalization of the atlas. This 39-year-old man had AOD following a motor vehicle collision. On examination, his overall motor score on the American Spinal Injury Association scale was 5\/100, and his rectal tone was absent. Computed tomography demonstrated AOD in an area of occipitalization. Magnetic resonance imaging revealed ligamentous injury leading to C1\u20132 instability.<\/jats:p>\n<jats:p>Intervention included occipital cervical instrumentation fusion from the occiput to C-3. Six months postoperatively, imaging revealed fusion of the graft and consolidation of the fractured occipitalization. At the 2-year follow-up, the patient's strength was 3\/5 for wrist extension and handgrip on the right side and full strength in the rest of the myotomes. Bladder and bowel function was also normalized.<\/jats:p>\n<jats:p>A high-velocity collision led to disruption of the atlantooccipital ligaments and fracture of the occipitalized lateral masses in this patient. Internal fixation and fusion led to good fusion postoperatively. Occipitalization probably led to abnormal joint mechanics at the C1-occiput junction, which might have altered the amount of force required to fracture the occipitalization and produce AOD. This difference may partially account for the favorable neurological outcome in the featured patient compared with traditional cases of AOD.<\/jats:p>","DOI":"10.3171\/2012.10.spine12430","type":"journal-article","created":{"date-parts":[[2012,11,30]],"date-time":"2012-11-30T15:07:29Z","timestamp":1354288049000},"page":"189-193","source":"Crossref","is-referenced-by-count":9,"title":["A rare case of atlantooccipital dissociation in the context of occipitalization of the atlas, with a 2-year follow-up"],"prefix":"10.3171","volume":"18","author":[{"given":"Navjot","family":"Chaudhary","sequence":"first","affiliation":[{"name":"Department of Clinical Neurological Sciences;"},{"name":"Schulich School of Medicine, University of Western Ontario, London, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bill H.","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurological Sciences;"},{"name":"Schulich School of Medicine, University of Western Ontario, London, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin R.","family":"Gurr","sequence":"additional","affiliation":[{"name":"Division of Orthopaedics, Department of Surgery, London Health Sciences Centre; and"},{"name":"Schulich School of Medicine, University of Western Ontario, London, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stewart I.","family":"Bailey","sequence":"additional","affiliation":[{"name":"Division of Orthopaedics, Department of Surgery, London Health Sciences Centre; and"},{"name":"Schulich School of Medicine, University of Western Ontario, London, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher S.","family":"Bailey","sequence":"additional","affiliation":[{"name":"Division of Orthopaedics, Department of Surgery, London Health Sciences Centre; and"},{"name":"Schulich School of Medicine, University of Western Ontario, London, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-spine12430","series-title":"Ann Surg","first-page":"654","article-title":"III","volume":"47","author":"Blackwood","year":"1908"},{"key":"b2-spine12430","series-title":"Radiographics 20 Spec No","first-page":"S237","article-title":"Radiologic spectrum of craniocervical distraction injuries","author":"Deliganis","year":"2000"},{"key":"b3-spine12430","series-title":"N C Med J","first-page":"34","article-title":"Atlantocranial dislocation with survival; a case report","volume":"9","author":"Farthing","year":"1948"},{"key":"b4-spine12430","series-title":"J Bone Joint Surg Am","doi-asserted-by":"publisher","first-page":"571","DOI":"10.2106\/00004623-200703000-00014","article-title":"Occipitalization of the atlas in children. 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