title: Diagnosis and management of traumatic atlanto-occipital dislocation injuries.
abstract: There is insufficient evidence to support diagnostic standards.
  
  
  
  There is insufficient evidence to support diagnostic guidelines.
  
  
  
  A lateral cervical x-ray is recommended for the diagnosis of atlanto-occipital dislocation. If a radiological method for measurement is used, the basion-axial interval-basion-dental interval method is recommended. The presence of upper cervical prevertebral soft tissue swelling on an otherwise nondiagnostic plain x-ray should prompt additional imaging. If there is clinical suspicion of atlanto-occipital dislocation, and plain x-rays are nondiagnostic, computed tomography or magnetic resonance imaging is recommended, particularly for the diagnosis of non-Type II dislocations.
  
  
  
  
  
  
  
  There is insufficient evidence to support treatment standards.
  
  
  
  There is insufficient evidence to support treatment guidelines.
  
  
  
  Treatment with internal fixation and arthrodesis using one of a variety of methods is recommended. Traction may be used in the management of patients with atlanto-occipital dislocation, but it is associated with a 10% risk of neurological deterioration.
authors.forename: M N
authors.initials: MN
authors.lastname: Hadley
authors.forename: B C
authors.initials: BC
authors.lastname: Walters
authors.forename: P A
authors.initials: PA
authors.lastname: Grabb
authors.forename: N M
authors.initials: NM
authors.lastname: Oyesiku
authors.forename: G J
authors.initials: GJ
authors.lastname: Przybylski
authors.forename: D K
authors.initials: DK
authors.lastname: Resnick
authors.forename: T C
authors.initials: TC
authors.lastname: Ryken
mesh_terms: D001269:Atlanto-Occipital Joint / Q000293:injuries* / Q000473:pathology; D019091:Critical Pathways / Q000592:standards; D019317:Evidence-Based Medicine; D006801:Humans; D004204:Joint Dislocations / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D009460:Neurologic Examination; D017410:Practice Guidelines as Topic / Q000592:standards; D013124:Spinal Injuries / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed