Traumatic atlantoaxial dislocation.

Abstract In our series of traumatic atlantoaxial injuries we found a 21% incidence of dislocation without an associated fracture of the odontoid process (7 of 33 cases). Clinically these patients initially exhibited associated cranial trauma (5 cases), cervical pain and headache (5 cases), subjective neurological complaints (5 cases), and objective neurological abnormalities (4 cases); in 4 patients, diagnosis was delayed because diastasis of the atlantoaxial joint was not recognized on lateral cervical radiograms. The wide spectrum of clinical presentations is partially accounted for by the varying degrees of injury to the transverse atlantal ligament and other associated ligamentous injuries. The findings in this series emphasize the need for awareness of this disorder, which may represent a significant number of the injuries to the region.