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PubMed1987

Injuries of the atlas and axis. A follow-up study of 85 axis and 10 atlas fractures.

In a follow-up study of ten atlas and 85 axis fractures, 12% had residual symptoms in the form of local and radiating cervical pain. The residual symptoms were interpreted as a sign of a mild demyelinating process initiated by the trauma of the medulla. At least 22% of the accidents occurred while the person was under the influence of drugs or alcohol. Therefore, a wide range of residual symptoms (progressive or nonprogressive) could be attributed in part to abuse of drugs and alcohol. A permanent measurable loss of motion occurred following injury to the atlas or axis, irrespective of the modality of treatment. Cervical fusion created the greatest loss of motion and collar immobilization the least. Skull traction and a halo-vest were intermediate in patients with loss of motion, and the degree of loss of range was essentially equal. Residual symptoms, including pain, were found in 20% of those treated with a collar, 40% of those treated with surgical methods, 5% of those treated with traction, and 5% of those treated with a Halo-vest. Residual symptoms did not correlate at all with degree of displacement of the original fracture.

Adult↗
PubMed1975

Lesions of the atlas and axis.

The atlas and axis support the head on the lower cervical spine while providing for considerable mobility in flexion, extension, rotation and lateral bending. The first two vertebrae also function as conduits for the cervical cord and vertebral arteries. Lesions of the atlas and axis, therefore, can cause instability with loss of support and encroachment on the upper cord and vertebral arteries, or less often stiffness with restricted motion. Congenital lesions of the occipito-cervical spine such as occipitalization of the atlas or accessory occipital vertebrae can constrict the upper cord with osseous, dural, or fibrous compression. Such encroachment on the cord at this level produces a varying array of clinical complaints and findings frequently difficult to interpret. Instability of the upper cervical spine can result from congenital, traumatic, inflammatory or neoplastic disruptions of the interlocking mechanism of the atlas and axis. Such factors as the loss of structural integrity of the dens or stretching or tearing of the transverse ligament can permit instability with cord involvement. Because of the serious potential of these lesions, patients with abnormalities of the atlas and axis require prompt recognition and treatment.

Adolescent↗
PubMed2001

Estimation of fetal age from dimensions of atlas and axis ossification centers.

The atlas and axis ossification centers of 106 human fetal and neonate skeletons were measured. The skeletons belong to the collection in the Department of Forensic Medicine of the Albert Szent-Györgyi Medical University, Szeged, Hungary. The age of the skeletons ranged from 4 to 10 lunar months. Nine linear measurements on the atlas, seven on the axis neural arches ossification centers and three on each one of the axis centra ossification centers were taken. We did simple and multiple linear regression analysis to estimate the age of fetuses. The results show that it is possible to use regression equations to estimate the fetal body length and age from atlas and axis ossification centers measurements during the whole period of development studied. The study of size and shape of the ossification centers using factorial analysis (principal component analysis) shows that the shape of the dens of the axis might be useful to estimate fetal viability.

Age Determination by Skeleton↗
PubMed1990

Postnatal ossification centers of the atlas and axis in miniature schnauzers.

Postnatal ossification of the atlas and axis was studied in Miniature Schnauzers by examining alizarin-stained bone clearings, cleaned dry bones, radiographs, histologic sections, and arterially perfused bone clearings. Sixty-two pups (1 day to 16 weeks old) and 4 adults were examined. In 1-day-old pups, the atlas consisted of 3 separate ossification centers: a left and right neural arch center and midventrally, the intercentrum 1, which formed the body of the atlas. The axis contained 4 separate ossification centers: a left and right neural arch center; centrum 2 in the main part of the axis body; and centrum 1, which formed the caudal part of the dens and the cranial part of the axis body. By 6 weeks of age, the epiphysis on the caudal end of the axis body had begun to ossify. At this time, the intercentrum 2, which developed as a cuboidal ossification center intercalated between centrum 1 and centrum 2 in the middle of the cranial half of the axis body, also began to ossify. The centrum of the proatlas, which formed the apex of the dens, was first seen ossified in a 9-week-old pup. These 10 ossification centers were seen as constant and separate elements. In all dogs, the dens developed from 2 separate ossification centers: the centrum of the proatlas formed the cranial one-quarter, and centrum 1 formed the caudal three-quarters. Dens dysplasia is unlikely to be a result of failure of development of one of the ossification centers for the dens.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1977

A case of rotary dislocation of atlas on axis.

An unusual case of rotary dislocation of atlas upon axis is presented. Included in the article are associated causes, the articulations of the area, a case history and radiological assessment. The article ends with the radiographic and technical factors involved.

Adolescent↗
PubMed2002

Management of combination fractures of the atlas and axis in adults.

STANDARDS: There is insufficient evidence to support treatment standards. GUIDELINES: There is insufficient evidence to support treatment guidelines. OPTIONS: Treatment of atlas-axis combination fractures based primarily on the specific characteristics of the axis fracture is recommended. External immobilization of most C1--C2 combination fractures is recommended. C1--Type II odontoid combination fractures with an atlantodens interval of 5 mm or more and C1--hangman's combination fractures with C2--C3 angulation of 11 degrees or more should be considered for surgical stabilization and fusion. In some cases, the surgical technique must be modified as a result of loss of the integrity of the ring of the atlas.

Adult↗
PubMed1998

[Radiologic description of the growth plates of the atlas and axis in foals].

Fractures of the first two cervical vertebrae, atlas and axis, may occur in foals for different reasons, e.g. in cases of a fall, going head over heels or when being hit by a hoof. The tentative clinical diagnosis can be confirmed by x-raying the standing animal, with aid of computed tomography in the anaesthetized foal respectively. The growth plates however, and their time of closure have to be considered when interpreting radiographs. In the atlas there are two ventrolateral plates and one dorsomedian cartilagineous plate. Only the dorsal plate, however, can be found in the dorsoventral projection up to an age of about 12 months. The ventrolateral growth plates which have closed at about six months of age cannot be seen in either ther dorsoventral or laterolateral projection. In transversely oriented CT-scans all of the three centres of ossification can easily be made visible in the atlas. In the axis the cartilagineous gaps between the dens axis and the cranial epiphysis as well as the cranial and caudal epiphyseal growth plate can be shown in normal x-radiographs in both planes of projection. Besides this there are growth plates between the corpus vertebrae and the arcus vertebrae in the axis which cannot be seen in either radiographic projection. They become clearly visible in transversal CT-scans and are ossified at the age of three to four months. At the end of the first year the growth plates between the dens axis and the cranial epiphysis have closed. The cranial and caudal epiphyseal plate are gone at an age of about four to five years.

Animals↗
PubMed1984

Stable fractures of the atlas and axis in children.

Three cases of stable fractures of the atlas and axis in children are presented. All patients presented with pain, spasm of neck musculature and head tilt along with a neurological deficit. All fractures were apparently stable; with conservative treatment all symptoms and signs resolved.

Axis, Cervical Vertebra↗
PubMed1986

Combined atlas and axis fractures visualized by computerized tomography.

Combined fractures of the atlas and axis are rare, with only four cases reported in the English literature. Combined fractures occur most frequently in the elderly. Computerized axial tomography and other special techniques are required for adequate visualization of these complex fractures.

Aged↗
PubMed1997

An atlas vertebra with a centrum? A case report of an abnormal atlas and axis.

This case report represents the finding of an abnormal atlas vertebra during dissection of 34 cadavers. The case which we describe appeared to have an atlas with a mass at a position similar to that of a centrum. This mass may have been a developmental abnormality of the centrum of the atlas or may have represented a congenital abnormality, known as the os odontoideum. Alternatively the abnormality may have been due to non-union of an odontoid fracture, with subsequent fusion to the atlas. The case report will discuss which of these three alternatives is more probable, and the embryology and phylogenesis of the atlas and axis, leading us to believe in a congenital hypothesis as an explanation for the malformation.

Cadaver↗
PubMed1988

A contribution to the anatomic basis of the transoral approach to the atlas and axis.

The transoral approach (Fang and Ong 1962) allows direct free exposure of the atlas and axis. However, a morphologic description of certain structures at risk corresponding to the views at operation has so far been lacking. The present study is intended to fill this gap by giving the surgeon a transoral view of the peripharyngeal structures. This is a further instance of how classical gross anatomy needs to be continuously rediscovered in the light of clinical activities.

Axis, Cervical Vertebra↗