Non-traumatic posterior atlanto-occipital joint dislocation.

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Radiology

Background:

• Non-traumatic posterior atlanto-occipital dislocation is a rare condition.
• Patients may present with chronic neck pain, vertigo, and extremity numbness.
• Limited range of motion, particularly axial rotation, can be a key clinical sign.

Observation:

• A 36-year-old female presented with a year-long history of neurological symptoms without trauma.
• Radiographic and CT imaging revealed posterior atlanto-occipital dislocation with bilateral joint angle loss and flatness.
• Severe restriction in cervical spine axial rotation was noted.

Findings:

• Instrumented occipito-cervical fusion was performed following successful reduction of the dislocation.
• Post-operative imaging at one year confirmed sustained reduction and maintained joint alignment.
• The patient experienced significant neurological improvement and enhanced cervical spine function.

Implications:

• Flattening of the atlanto-occipital joint may predispose individuals to instability.
• Occipito-cervical fusion is an effective treatment for non-traumatic atlanto-occipital dislocation with restricted motion.
• This case highlights the importance of considering rare spinal pathologies even in the absence of trauma.