Research Progress of Atlantoaxial Osteoarthritis: A Narrative Literature Review

Abstract

To consolidate the current literature related to atlantoaxial osteoarthritis (AAOA) and improve systematic understanding of this clinical syndrome among spine surgeons. A comprehensive literature search was performed using PubMed, Ovid MEDLINE, and EMBASE databases and the following search terms: ("C1-C2" OR "C1-2" OR "atlantoaxial" OR "atlanto-axial" OR "C2" OR "C1" OR "atlas" OR "axis") AND ("osteoarthritis"). All articles of any study design addressing AAOA were considered for inclusion. Two authors independently read article titles and abstracts, and the full text of included relevant articles. There were 54 articles reviewed and consolidated in this narrative review. These articles are roughly divided into the following 5 subcategories: epidemiology and etiology, clinical presentation, radiographic findings, conservative treatment, and surgical indications and treatment options. AAOA is a clinically common but often overlooked syndrome characterized by persistent occipitocervical pain. The most common cause of AAOA is joint degeneration, which is closely related to age and occupation. AAOA is initially managed with conservative treatment. Atlantoaxial fusion is an option for patients with severe pain who are unresponsive to conservative treatment.