{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:59:58Z","timestamp":1787169598471,"version":"build-2736575974"},"reference-count":8,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>We report the case of a 57-year-old man who developed osteoradionecrosis (ORN) at the occipitocervical (OC) junction after radiation therapy for nasopharyngeal carcinoma. During soft-tissue debridement using a nasopharyngeal endoscope, the anterior arch of the atlas (AAA) was spontaneously disrupted, which was later spat out. Radiographic examination revealed complete disruption of the AAA that caused OC instability. We performed posterior OC fixation. The patient experienced successful postoperative pain relief. AAA disruption secondary to ORN at OC junction can cause severe instability. Posterior OC fixation alone may be an effective procedure if the necrotic pharyngeal region is mild and endoscopically controllable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jcvjs.jcvjs_145_22","type":"journal-article","created":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T02:36:05Z","timestamp":1678674965000},"page":"93-96","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Osteoradionecrosis of the occipitocervical junction"],"prefix":"10.4103","volume":"14","author":[{"given":"Masaki","family":"Sakamoto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayoshi","family":"Shimizu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Suehiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuichi","family":"Matsuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-15-20240904","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/0167-8140(95)01583-3","article-title":"Radionecrosis of the mandibula: A retrospective analysis of the incidence and risk factors","volume":"36","author":"Glanzmann","year":"1995","journal-title":"Radiother Oncol"},{"key":"R2-15-20240904","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/j.ejrad.2008.12.016","article-title":"Osteoradionecrosis of the upper cervical spine: MR imaging following radiotherapy for nasopharyngeal carcinoma","volume":"73","author":"King","year":"2010","journal-title":"Eur J Radiol"},{"key":"R3-15-20240904","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.oraloncology.2019.01.013","article-title":"The prevalence and impact of cervical spine pathologies in patients with nasopharyngeal carcinoma","volume":"90","author":"Yung","year":"2019","journal-title":"Oral Oncol"},{"key":"R4-15-20240904","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.clon.2014.10.005","article-title":"Evidence-based estimates of the demand for radiotherapy","volume":"27","author":"Delaney","year":"2015","journal-title":"Clin Oncol (R Coll Radiol"},{"key":"R7-15-20240904","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1007\/s00066-004-1171-z","article-title":"Osteoradionecrosis of the mandibula in patients treated with different fractionations","volume":"180","author":"Studer","year":"2004","journal-title":"Strahlenther Onkol"},{"key":"R8-15-20240904","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.wneu.2019.02.177","article-title":"Craniocervical osteoradionecrosis treated with neoadjuvant and adjuvant hyperbaric oxygen in combination with posterior spinal fusion","volume":"126","author":"West","year":"2019","journal-title":"World Neurosurg"},{"key":"R9-15-20240904","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.1097\/00006534-200204010-00024","article-title":"Simultaneous reconstruction of the posterior pharyngeal wall and cervical spine with a free vascularized fibula osteocutaneous flap","volume":"109","author":"Ng","year":"2002","journal-title":"Plast Reconstr Surg"},{"key":"R10-15-20240904","doi-asserted-by":"crossref","first-page":"159","DOI":"10.3171\/spi.2005.3.2.0159","article-title":"Osteoradionecrosis of the cervical spine resulting from radiotherapy for primary head and neck malignancies: Operative and nonoperative management. Case report","volume":"3","author":"Donovan","year":"2005","journal-title":"J Neurosurg Spine"}],"container-title":["Journal of Craniovertebral Junction and Spine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jcvjs.jcvjs_145_22","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:09:35Z","timestamp":1787166575000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jcvjs.jcvjs_145_22"}},"subtitle":["A rare case of C1 anterior arch disruption"],"short-title":[],"issued":{"date-parts":[[2023,1]]},"references-count":8,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/jcvjs.jcvjs_145_22","relation":{},"ISSN":["0974-8237"],"issn-type":[{"value":"0974-8237","type":"print"}],"subject":[],"published":{"date-parts":[[2023,1]]}}}