Abstract
The occipitoatlantal junction accounts for the majority of flexion-extension of the head. This critical junction comprises the bony occiput and the atlas—articulated at the bilateral occipital condyles and C1 facets. The ligamentous anatomy of the craniovertebral junction (CVJ) plays a crucial role in the structural stability of this region, and this area is often affected in traumatic injury. The ligaments in this area include intrinsic ligaments, which account for the majority of mechanical support, as well as extrinsic ligaments. Because of their large head size and ligamentous laxity, children are more prone to purely ligamentous injury, including occipitoatlantal dislocation and transverse ligament damage after high-velocity trauma. Bony injury in this location includes fractures of the occipital condyles, or atlas, similarly following a high-energy collision. This chapter will outline the anatomy, biomechanics, prevalence, diagnostic features, and treatment options for both ligamentous and bony injuries to the occipitoatlantal junction.
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