What is Occipitocervical Junction?

The occipitocervical junction (OCJ) is a highly specialized area of the spine. Understanding the unique anatomy, imaging, and craniometry of this area is paramount in recognizing and managing the potentially devastating effects that pathology has on it.

What causes atlanto-occipital dislocation?

Atlanto-occipital dislocation (AOD) is a devastating condition that frequently results in prehospital cardiorespiratory arrest and accounts for 15% of fatal spinal trauma. Atlanto-occipital dislocation occurs 5 times more commonly in children than adults, and is believed to be caused by hyperextension.

What is C1 and C2 responsible for?

The C1 vertebrae is named atlas and the C2 vertebrae is named axis. As well as protecting the spinal cord, these vertebrae are primarily responsible for facilitating and controlling the large range of movement that your neck has, and supporting the considerable weight of your skull at the tip of your spine.

How is Craniocervical instability treated?

Treatment. Conservative treatment of craniocervical instability includes physical therapy and the use of a cervical collar to keep the neck stable. Cervical spinal fusion is performed on patients with more severe symptoms.

What is a halo vest?

A halo-vest is a brace that is used to immobilize and protect the cervical spine and neck after surgery or accident. The halo is a ring that surrounds the head and is attached by pins to the outer portion of the skull; however, some Halos are pinless but are only used in certain situations.

What movement does the atlanto-occipital joint allow?

Being an ellipsoid joint, the atlantooccipital joint allows movement in two degrees of freedom. These are flexion-extension and lateral flexion.

What nerves are affected by C1 C2?

C1, C2, and C3 (the first three cervical nerves) help control the head and neck, including movements forward, backward, and to the sides. The C2 dermatome handles sensation for the upper part of the head, and the C3 dermatome covers the side of the face and back of the head.

What does craniocervical instability feel like?

Symptoms of craniocervical instability include occipital headache, neck pain and neurological abnormalities such as numbness, motor weakness, dizziness, and gait instability. Patients sometimes describe the feeling that their head is too heavy for their neck to support (“bobble-head”).

How do I know if I have craniocervical instability?

Diagnosis. Craniocervical instability is usually diagnosed through neuro-anatomical measurement using radiography. Upright magnetic resonance imaging is considered the most accurate method, and supine magnetic resonance imaging, CT scan or digital motion X-ray, or Digital X-ray are also used.

How do you sleep in a halo?

Nighttime suggestions include sleeping in a reclining chair and lying on the back with a small pillow or foam wedge. Eventually, sleeping on a side or on the stomach may be possible. When getting up, it is important to not sit upright and bend at the waist.

Can you use a pillow with halo device?

It will take time to adjust sleeping with the Halo Vest System on. You may use pillows to help support you if it is comfortable. Using a rolled towel under your neck will also give the feeling your neck is supported and may help with comfort.

How many people have survived atlanto-occipital dislocation?

Meta-analysis of the literature between 1948 and present showed 211 patients surviving AOD including 131 (62%) children [2, 4, 9, 12, 13, 15, 17, 18, 20, 22, 23, 24, 25, 27, 28, 29, 30, 31, 34, 35, 38, 41, 44, 45, 46, 47, 52, 54, 56, 60, 61, 62, 64, 65, 68, 69, 71, 73, 74, 75, 77, 78, 79, 80, 81, 82, 83, 84, 88, 89, 93 …