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Craniocervical instability (CCI) is a medical condition characterized by excessive movement of the vertebra at the atlanto-occipital joint and the atlanto-axial joint located between the skull and the top two vertebra, known as C1 and C2.
The body is innervated by spinal nerves that branch off from the spinal cord. [18] This innervation enables the brain to receive sensory inputs and send motor outputs. There are 8 cervical spinal nerves of the peripheral nervous system. Cervical spinal nerves C1, C2 and C3 help control the movements of the head and neck.
The atlas (C1) and axis (C2) are the two topmost vertebrae. The atlas (C1) is the topmost vertebra, and along with the axis forms the joint connecting the skull and spine. It lacks a vertebral body, spinous process, and discs either superior or inferior to it. It is ring-like and consists of an anterior arch, posterior arch, and two lateral masses.
In 1953, further complications were later reported by McRae; flexion and extension is concentrated within the C1 and C2 vertebrae. As with aging, the odontoid process can become hypermobile, narrowing the space where the spinal cord and brain stem travel (spinal stenosis). Type II—Long fusion below C2 with an abnormal occipital-cervical junction.
The Jefferson fracture can be associated with this injury, with the C1 ring, or atlas, being fractured in several places, allowing the spine to shift forward relative to the skull base. The Hangman's fracture which is a fracture of the C2 vertebral body or dens of the cervical spine upon which the skull base sits to allow the head to rotate ...
The worst-case scenario for these injuries is that dislocation or subluxation of the cervical vertebrae occurs. This often happens at the C2 level, where the body of C2 moves anteriorly with respect to C3. Such an injury may well lead to spinal cord involvement, and as a consequence quadriplegia or death may occur.
He would come to learn he had a spinal cord injury at his C2 vertebrae, meaning he was paralyzed from the neck down. Mackay now is an advocate promoting wheelchair accessibility on outdoor trails.
55% of facet syndrome cases occur in cervical vertebrae, and 31% in lumbar. Spinal osteoarthritis is known as spondylosis. [7] Pathology of the C1-C2 (atlantoaxial) joint, the most mobile of all vertebral segments, accounts for 4% of all spondylosis. [8]