Lateral view in the neutral position shows an atlantodental interval of 3.2 mm (c-1) and in the flexed position shows an atlantodental interval of 2.4 mm (c-2). However, the asymmetry of the lateral atlantodental interval is occasionally found in healthy individuals. Journal of Manipulative and Physiological Therapeutics, 2013. eCollection 2021. Peter Osmotherly. 2018 Aug;22(2):195-199. doi: 10.3171/2018.2.PEDS17694. https://medical-dictionary.thefreedictionary.com/atlantodental+interval, Type 2: unilateral facet subluxation with an, Previous investigations declared that the posterior, Some cases are reported to be asymptomatic until the spinal cord is irreversibly compromised at a posterior, A report of two cases described subjects with idiopathic atlantoaxial instability (measured as 8 mm, Dictionary, Encyclopedia and Thesaurus - The Free Dictionary, the webmaster's page for free fun content, Fusion Surgery Required for Recurrent Pediatric Atlantoaxial Rotatory Fixation after Failure of Temporary Fixation with Instrumentation, Rheumatoid Arthritis Affecting the Upper Cervical Spine: Biomechanical Assessment of the Stabilizing Ligaments, PATTERNS OF RADIOGRAPHIC DAMAGE TO CERVICAL SPINE IN POLYARTICULAR JUVENILE IDIOPATHIC ARTHRITIS PATIENTS PRESENTING TO TERTIARY CARE HOSPITAL IN PAKISTAN, Conservative management of idiopathic anterior atlantoaxial subluxation without neurological deficits in an 83-year-old female: a case report, Characterizing traumatic spinal injury at the atlantoaxial junction, Case Report of a Traumatic Atlantoaxial Rotatory Subluxation with Bilateral Locked Cervical Facets: Management, Treatment, and Outcome, Atlanta Classification of Acute Pancreatitis, atlanto-occipital malformation of Arab horses. METHODS. The aim of this study was to evaluate relationships between atlantodental interval, cervical vertebral morphology, and facial structure in healthy adolescents using cone beam computed tomography. Fig. Found inside – Page 303A severe anterior dislocation of the atlas on the axis was confirmed after measuring the atlantodental interval ( 6 mm ) . For this case , no fracture of ... Found insideChange of AtlantoDental Interval. The atlantodental interval (ADI) changed from an average of 8.8 mm preoperatively to 4.5 mm postoperatively (Fig. 1). Atlantoaxial instability (AAI) is characterized by excessive movement at the junction between the atlas (C1) and axis (C2) as a result of either a bony or ligamentous abnormality. (accessed on 22 Sep 2021) https://radiopaedia.org/articles/40483, {"containerId":"expandableQuestionsContainer","displayRelatedArticles":true,"displayNextQuestion":true,"displaySkipQuestion":true,"articleId":40483,"mcqUrl":"https://radiopaedia.org/articles/atlantodental-interval/questions/1812?lang=us"}. How much lateral atlantodental interval asymmetry and atlantoaxial lateral mass asymmetry is acceptable on an open-mouth odontoid radiograph, and when is additional investigation necessary? However, the asymmetry of the lateral atlantodental interval is occasionally found in healthy individuals. One series 11 claimed that using a PADI of ≤ 14 mm yielded a sensitivity (ability to detect patients with paralysis) of 97%. AAI is defined as an atlantodental (or atlantodens or atlas-dens) interval (ADI) of greater than 3 mm in adults and of greater than 5 mm in children as measured on plain radiography. Found inside – Page 833A, lateral x-ray inflexion shows severe anterior atlantoaxial subluxation with a wide anterior atlantodental interval (asterisks) and a decreased posterior ... The Atlantodental Interspace (ADI) This section is compiled by Frank M. Painter, D.C. Studies suggest that the posterior atlantodental interval (PADI) is a better method of assessing AAS because the PADI directly measures the spinal canal and therefore shows how much is narrowed by . The left LADI was found to be 3.38 ± 0.87 mm (1.7-6.0 mm), and the right LADI was 3.42 ± 0.84 mm (1.7-5.9 mm) in males, while the left LADI was 3.30 ± 0.73 mm (1.5-5.3 mm) and the right LADI was 3.37 ± 0.92 mm (1.7-5.9 mm) in females. Reference ranges for atlantodental interval in adults and its variation with age and gender in a large series of subjects on multidetector computed tomography Kai Liu, Fubo Xie, Daocai Wang, Lingfei Guo, Yuangang Qi, Jun Tian, Bin Zhao, Avneesh Chhabra The 95% confidence interval for AADI was 1.75-1.90 mm in males and 1.54-1.72 mm in females. Found inside – Page 1003he in of normal measurement children and 3 mm in the atlantoaxial articulation. of the atlantodental interval (ADI) is less than or equal to 5 mm adults. The use of the posterior atlantodental interval (PADI)—the distance between the posterior aspect of the dens to the anterior aspect of the C1 lamina—has been recommended as an alternative. atlantoaxial subluxation: Orthopedics An upper cervical spine subluxation which is either rotatory or anterior; rotatory AAS is more common in children, often due to apparently trivial injury; torticollis may be seen Imaging On an open mouth film, the odontoid is not equidistant between lateral masses of C1 Management Reduce subluxation and . The cause of cervicogenic headache within the framework of atlantodental osteoarthritis is sclerosis of the atlantodental joint. Atlantodental joint or interval. Found inside – Page 19Atlantodental Interval The atlantodental interval (ADI) is the distance between the posterior border of the anterior arch of the atlas and the anterior ... However, atlantoaxial fusion sacrifices the motion of atlantoaxial articulation, and postoperative loss of cervical lordosis and aggravation of cervical kyphosis are observed. The atlantodental interval (ADI) is the horizontal distance between the anterior arch of the atlas and the dens of the axis, used in the diagnosis of atlanto-occipital dissociation injuries and injuries of the atlas and axis. Methods: Ninety-nine consecutive patients who had CT scans of the atlanto-axial complex for reasons unrelated to the upper cervical spine were studied. Found inside – Page 252Normal atlantodental interval is again seen. (Right) Fielding type I rotatory fixation: Anterior view from a volume CT reconstruction shows the morphology ... Found inside – Page 25The dislocation was considered reducible when the atlantodental interval returned to normal on head extension; it was considered irreducible or fixed or ... Asymmetry of the Odontoid Lateral Mass Interval in Pediatric Trauma CT: Do We Need to Investigate Further? When the distance on X-ray between the atlas (1st vertebra) and odontoid process (2nd vertebra) is more than […] LADI asymmetry may be a normal anatomic variant and there is no evidence to confirm that LADI asymmetry is a sensitive or specific indicator of traumatic atlantoaxial instability. 1960 Nov;84:945-51 As subluxation . Development and first application testing of a new protocol for CT-based stability evaluation of the injured upper cervical spine. Found inside – Page 159The atlantodental interval should never exceed 3mm in adults and 5mm in children. If the 3mm or 5mm atlantodental interval distance in the lateral ... We defined the AAS as an AADI of > 3 mm, and progression of AADI as a progression rate > 0.5 mm/year. Evaluation of traumatic widening of the atlantoaxial interval is a big challenge, as many times injuries can be symmetric. Occurrence and significance of odontoid lateral mass interspace asymmetry in trauma patients. 1. showing an anterior atlantodental interval (ADI) on a flexion radiograph of 5mm or more [10, 11]. The medical records of the patients were retrospectively reviewed and the anterior atlantodental interval (AADI) in the lateral flexion view of the cervical spine radiograph was investigated by 2 experienced musculoskeletal radiologists. 2007;28 (9): 1819-23. The directionality of head, C1, and C2 rotation was significantly (P < .05) more toward the same direction in the noninjured group. Found inside – Page 18... the accessory atlantoaxial ligament, and the atlantodental ligament may ... the anterior atlantodental interval (ADI) and the posterior atlantodental ... 1986 Oct;15(10 ):1173-6 Found inside – Page 237Atlantoaxial instability can be diagnosed on the basis of an abnormal increase of atlantodental interval and also on the basis of abnormalities in facetal ... The current study shows that LADI asymmetry is common in patients without any cervical spine abnormalities. Os odontoideum. Guenkel S, Scheyerer MJ, Osterhoff G, Wanner GA, Simmen HP, Werner CM. atlantodental interval in pediatric patients to help avoid misinterpretation of radiographic findings and resultant excessive imaging. Eur J Trauma Emerg Surg. Found inside... magnification factor, it has been suggested that the criteria be increased to 2 8.2 mm45) (Anterior) atlantodental interval (ADI)A AKA predental space. Controversy therefore exists as to the clinical significance of this asymmetry in patients after trauma. Surgery for BHS The patient underwent an IRB-approved C1-C2 posterior fusion using O-arm navigation. Pseudoaneurysm of the breast: the use of color Doppler sonography. Found inside – Page 571In lateral views, an atlantodental interval (ADI) greater than 3 mm in adults and ... the transverse ligament integrity.12 Posterior atlanto dental interval ... 2021 May 25. doi: 10.1007/s00068-021-01702-3. The anterior atlantodental interval has been used as an objective indicator of anterior atlantoaxial subluxation. Atlantoaxial subluxation is manifested in the presence of rheumatoid arthritis, by pannus formation, ligamentous distention, synovitis and bone resorption (Kuhr et al., 1996). V L Schiller, L Karlen, R J Brenner. Radiography in extension showed three patients with pAAS whereas MRI in neutral position detected only one of them. Down's syndrome. Atlantoaxial Osteoarthritis is a metabolically active, dynamic process that involves all joint tissues such as cartilage, synovium/capsule, ligaments and muscles. 1,2 The AtlantoDental Interval (ADI) is defined as the distance between the anterior edge of the odontoid process of the second cervical vertebra and the posteroinferior edge of the anterior arch of the atlas, and is used . The ADI is often constant in distance during movement of the head and generally does not exceed 3 mm for adults and 5 mm for children. Pathophysiology. The atlantodental interval (ADI) is measured between the posterior aspect of the anterior atlas ring and the anterior aspect of the odontoid process. 2005 Nov;59(5):1121-5 Kai Liu, Fubo Xie, Daocai Wang, Lingfei Guo, Yuangang Qi, Jun Tian, Bin Zhao, and Avneesh Chhabra. (Level of evidence 5, Level of evidence 1B) Radiologists and clinicians should be aware of this normal range of asymmetry when interpreting CT scans of the atlantoaxial region. The atlantodental interval, also known as the predental space, is maintained by the presence of the atlantodental ligament, alar ligaments, and transverse atlantal ligament. AAS greater than 9 mm with VT and a posterior atlantodental interval, measuring less than 14 mm, correlate with continuance of neurologic deficits . Abnormal anterior atlantodental interval were found in 11 patients (23.4%). Measure its distance from the dens on . Results. 2013 Aug;37(8):1988-95. doi: 10.1007/s00268-013-2048-z. Clipboard, Search History, and several other advanced features are temporarily unavailable. Evaluation of lateral atlantodental interval asymmetry in the pediatric age group: normative values. prone to instability by both degenerative and traumatic processes. Found inside – Page 51This distance is called the anterior atlantodental interval . TABLE 3.1 . Criteria for Upper Cervical Spine Instability > 8 ° Axial rotation CO - C1 to one ... All content on this website, including dictionary, thesaurus, literature, geography, and other reference data is for informational purposes only. Pseudoaneurysm of the breast: the use of color Doppler sonography. The ADI is determined by measuring the distance between the posterior edge of the anterior arch of C1 and the anterior edge of the dens. After reformatting the original images, the anterior atlantodental interval (AADI) and lateral atlantodental interval (LADI) were measured. Radiology. Accessibility Methods: Ninety-nine consecutive patients who had CT scans of the atlanto-axial complex for reasons unrelated to the upper cervical spine were studied. Found inside – Page 301Atlanto Axial Subluxation The most common radiographic measure of AAS if the atlantodental interval (ADI) which is normally less than 3 mm in adults. Jung MK, Hörnig L, Stübs MMA, Grützner PA, Kreinest M. Eur J Trauma Emerg Surg. Found inside – Page 28ATLAS - DENS INTERVAL Locke et al . measured the minimum distance between the ... ATLANTODENTAL INTERVAL ( mm ) 100 % HORIZONTAL DISPLACEMENT OF CERVICAL ... Found insideAn atlantodental interval of 3.5 to 5 mm in an adult indicates potential damage ... whereas an interval greater than 5 mm indicates probable injury to the ... In this study, C1-C2 vertebrae were imaged in 230 adult patients by a Lightspeed Vct CT (General Electric, CT, USA) with a slice thickness of 0.625 mm. 1987 Jul-Aug;12 (6):515-9 Found inside – Page 923(A) Lateral radiography in flexion shows severe anterior atlantoaxial subluxation with a wide anterior atlantodental interval (asterisks) and a decreased ... Key Words: cervical spine, atlantoaxial joint, atlantoaxial rotatory fixation (J Comput Assist Tomogr 2011;35: 557Y559) Interpretation of imaging studies of the pediatric cervical spine is challenging. 4). Found inside – Page 46Up to 3 mm of anterior translation of C1 on C2, as measured by the anterior atlantodental interval (AADI) on a lateral cervical radiograph, is normal. Found inside – Page 1487The SAC decreases with anterior subluxation as there is reduced posterior atlantodental interval (PADI, Figs 4A and B)) and ... Found inside – Page 48Figure 96. Anatomy of the atlas (the first cervical vertebra). Figure 97. Atlantodens interval (ADI) and posterior atlantodental (-dens) interval. Would you like email updates of new search results? Methods: Ninety-nine consecutive patients who had CT scans of the atlanto-axial complex for reasons unrelated to the upper cervical spine were studied. 8 This increased anterior atlantodental interval and decreased posterior atlantodental interval is apparent on lateral cervical spine radiographs, particularly with the neck in flexion . Widening of the joint can be used to detect instability at the C1-C2 level. The alar ligaments extend from the dens upward and laterally to the occipital condyles, and the apical ligament extends from . Found inside – Page 20Up to 3 mm of anterior translation of the atlas on the axis, as measured at the anterior atlantodental interval (AADI), is normal. If this interval is ... The directionality of head, C1, and C2 rotation was significantly (P < .05) more toward the same direction in the noninjured group. Rojas CA, Bertozzi JC, Martinez CR et-al. Thus, an abnormally widened predental space is an indirect indicator of craniocervical junction ligamentous injury, . The atlantodental interval has been usually used for the evaluation of atlantoaxial instability. The atlantodental joint or interval is the space between the anterior arch of C1 and the dens (orange). AJNR Am J Neuroradiol. The normal atlantodental (or atlantodens or atlas-dens) interval (ADI) in children is less than 4 mm on a neutral-position lateral cervical spine radiograph. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Reference ranges for atlantodental interval in adults and its variation with age and gender in a large series of subjects on multidetector computed tomography. The atlantodental interval (ADI) is the horizontal distance between the anterior arch of the atlas and the dens of the axis, used in the diagnosis of atlanto-occipital dissociation injuries and injuries of the atlas and axis.. The LADI was measured at a . Epub 2015 Dec 11. Found inside – Page 29The atlanto-axial relationship can be described by means of an anterior atlantodental interval (AADI, predental space) on plain radiographs [20]. 3). Found inside – Page 390Anterior atlantoaxial subluxation can be assessed by measuring the anterior atlantodental interval (AADI) on a lateral cervical spine radiograph (Fig. L. Rowe. The purpose of this analysis was to determine the normal range of asymmetry of the lateral atlantodental interval (LADI) and define age- and sex-related differences. The purpose of this study was to determine the normal range of atlantodental intervals . Send all comments or additions to: Frankp@chiro.org The ADI is measured from the inferior border of the anterior tubercle of the C1 arch to the Odontoid process (Dens) of C2. The normal atlantodental (or atlantodens or atlas-dens) interval (ADI) in children is less than 4 mm on a neutral-position lateral cervical spine radiograph. Found inside – Page 360The use of the posterior atlantodental interval with a cut - off of 314 mm yields a sensitivity of 97 % , far superior to that of the anterior interval ... Conclusions: A small percentage of patients with Down syndrome are at risk for atlantoaxial instability and subluxation. Atlantoaxial subluxation may occur in up to 49% of RA patients and usually manifests as anterior subluxation of the atlas (C1) on the axis (C2). Evaluation of the lateral atlantodental interval : Draw a line tangent to the most medial point on the left and right lateral masses of C1. Note the increase to 6 mm and the decrease to 1 mm in the atlantodental interval with the flexion and extension views (arrows), respectively. Controversy therefore exists as to the clinical significance of this asymmetry in patients after … There was a significant difference in the atlantodental interval value (3.3 ± 0.8 mm in injured and 2.2 ± 0.5 mm in noninjured). Atlantodental Interval | Pharmacology nursing, Medical mnemonics, Human body lesson plans. It refers to a clinical syndrome of joint pain accompanied by varying degrees of functional limitation and reduced quality of life[1][2]. Reassessment of the craniocervical junction: normal values on CT. AJNR Am J Neuroradiol. Found inside – Page 277Whilst the anterior atlantodental interval has been shown to be of great use when assessing non-rheumatoid patients for the presence or absence of spinal ... Billmann F, Bokor-Billmann T, Burnett C, Kiffner E. World J Surg. Send all comments or additions to: Frankp@chiro.org The ADI is measured from the inferior border of the anterior tubercle of the C1 arch to the Odontoid process (Dens) of C2. Reduction was confirmed by CT scan. The most common cause is osteoarthritis between the dens (a bony projection of the axis) and the front of the atlas. On MR imaging C1 to C2 subluxation of 70° was observed, with preserved transverse ligaments (fig. Purpose: The object of this study is to determine the normal range of asymmetry of the lateral atlanto-dens interval (LADI). Small effusion in atlantoaxial joint was present. Axial CT views confirmed that the odontoid was lying eccentrically between the lateral masses of the atlas (E). Disclaimer, National Library of Medicine ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. The atlantodental interval was not increased and no fracture was identified. According to various reports, AAI affects from 6.8 to 27% of the population with DS. 1970), the atlantodental interval (ADI) >4 mm in adults, and MRI evidence of ligamentous disruption or avulsion. Check for errors and try again. However, the asymmetry of the lateral atlantodental interval is occasionally found in healthy individuals. Found inside – Page 673Anterior atlantodental interval (AADI) or ADI. This is the distance from the posterior aspect of the anterior ring of the atlas to the anterior aspect of ... Atlanto-axial instability (AAI) is a developmental anomaly often occurring in persons with Down's syndrome (DS). This site needs JavaScript to work properly. Scott Farrell. 2016 Jan;37(1):176-9. doi: 10.3174/ajnr.A4492. Atlantodental interval (ADI) was 4,8 mm, basilar invagination with preserved tectorial membrane was present (fig. Flexion and extension lateral radiographs of individuals investigated for atlantoaxial instability were measured for AADI on three occasions. The atlantodental interval (ADI), as the name suggests, is the horizontal distance between the anterior arch of the atlas and the dens of the axis, used in the diagnosis of atlanto-occipital dissociation injuries and injuries of the atlas and axis. Pathologic widening of this space is considered greater than 3 mm in an adult and 6 mm in a skeletally immature patient. Damage to the transverse ligament alone leads to approximately 3-4 mm of subluxation. The AADI was significantly greater in males than in females (p < 0.05). Bookshelf Rheumatoid disease of the spine is a morbid consequence of untreated longstanding severe cervical spinal rheumatoid arthritis (RA)-an inflammatory autoimmune disease that attacks the ligaments, joints, and bones of the neck.Although the anterior subluxation of the atlantoaxial joint is the most common manifestation of the disorder, subluxation can also occur with posterior or vertical . Sagittal CT views of the cervical spine indicated no abnormal findings (D). However, the asymmetry of the lateral atlantodental interval is occasionally found in healthy . Patients with AAS and no symptoms or signs of myelopathy can be observed when their lateral cervical radiograph shows a posterior atlantodental interval (PADI; the interval from the posterior . Controversy therefore exists as to the Controversy therefore exists as to the clinical significance of this asymmetry in patients after trauma. 2016 Dec;42(6):749-754. doi: 10.1007/s00068-015-0602-0. It may be associated with dislocation of the lateral mass of C1 on C2. Surg Neurol Int. The atlantodental interval has been usually used for the evaluation of atlantoaxial instability. The LADI was measured at a . It is the distance (in mm) between the posterior cortex of the anterior arch of the atlas and the anterior cortex of the dens in the median (midsagittal) plane. Assoc Prof Craig Hacking and Rishi Agrawal et al. Found inside – Page 149... is composed of two facet joints and the unique atlantodental articulation. ... atlantodental interval (AADI) and the posterior atlantodental interval ... Found inside – Page 258The increased atlantodental interval is also demonstrated as a manifestation of acquired atlantoaxial instability . Medicolegal Implications PLATYBASIA AND ... 2021 Aug 24;12:427. doi: 10.25259/SNI_679_2021. Atlantoaxial instability (AAI) is primarily a congenital neurologic disorder of young, toy breed dogs. We found significant linear correlation between head rotation and ipsilateral . traumatic. Children with an atlantodental interval of greater than 4.5 mm or with peripheral neurologic findings should have further evaluation. eCollection 2021.ABSTRACTBACKGROUND: The anterior atlantodental interval (AADI) and posterior atlantodental interval (PADI) on X-ray and computed tomography (CT) studies can both be used to gauge the risk and/or presence of neurological compression.METHODS: This retrospective observational study was conducted at a tertiary care . Headache due to atlantodental osteoarthritis falls under the cervicogenic headache group and is a clinically defined headache syndrome originating in the cervical nociceptors.. Aetiology. Atlantoaxial dislocation. This information should not be considered complete, up to date, and is not intended to be used in place of a visit, consultation, or advice of a legal, medical, or any other professional. The atlantodental interval (ADI) is the horizontal distance between the anterior arch of the atlas and the dens of the axis, used in the diagnosis of atlanto-occipital dissociation injuries and injuries of the atlas and axis. {"url":"/signup-modal-props.json?lang=us\u0026email="}, Hacking, C., Shah, V. Atlantodental interval. atlantodental interval: Neuroradiology The distance between the dens and anterior ring of C1, which is ≤ to 3 mm in adults, and ≤ 5 mm in children, which is altered in Pts with atlantoaxial subluxation. This allowed clinical reduction of the subluxation within one hour of application. 1991 Nov;9(4):719-32. Both are based on a transoral odontoid view. However, the asymmetry of the lateral atlantodental interval is occasionally found in healthy individuals. Found inside – Page 14The arrow indicates the atlantodental interval, which is taken between the posterior margin of the anterior C1 arch and the anterior surface of the odontoid ... MeSH Methods Thirty subjects aged 14-20 years (10 males, mean age: 17.2 years; 20 females, mean age: 17.9 years) were included in the study. PMC Endler CH, Ginzburg D, Isaak A, Faron A, Mesropyan N, Kuetting D, Pieper CC, Kupczyk PA, Attenberger UI, Luetkens JA. 2005 Oct;59(4):897-903; discussion 903-4 Definition. The mean asymmetry of LADI was 0.76 ± 0.66 mm (0.0-3.5 mm) in males and 0.73 ± 0.70 mm (0.0-3.7 mm) in females. The 95% confidence interval for LADI asymmetry was 0.65-0.87 mm in males and 0.59-0.88 mm in females. Causes. All patients with Down syndrome should have a preoperative neurologic assessment screening . In patients with cervical myelopathy and/or severe neck pain due to C1/2 instability, surgery was usually indicated. Mendenhall SK, Huh A, Pandya J, Alentado V, Balsara K, Ho C, Jea A. J Neurosurg Pediatr. Atlantodental interval-measurement from the posterior inferior cortical margin of the anterior arch of C1 to the anterior cortex of the dens. However, the asymmetry of the lateral atlantodental interval is occasionally found in healthy individuals. Found inside – Page 445The anterior shear test was assessed using changes in atlantodental interval and distance from the anterior arch of the atlas to the posterior aspect of the ... The patient was transferred to the regional neurosurgical centre. Peter Osmotherly. The atlantodental interval has been usually used for the evaluation of atlantoaxial instability. Lateral Atlantodental Interval. Online ahead of print. The osteoarthritis can be caused by wear . The Atlantodental Interspace (ADI) This section is compiled by Frank M. Painter, D.C. . The atlantodental ligament bridges the small space between the anterior aspect of the odontoid and the posterior aspect of the anterior arch of C1 (this space is referred to as the anterior atlantodental interval [AADI]). Plain roentgenographic and CT scan morphometric analysis of the anterior atlantodens interval (AADI) and posterior atlantodens interval (PADI) in the Indian population. Unable to load your collection due to an error, Unable to load your delegates due to an error. Please enable it to take advantage of the complete set of features! The craniocervical junction functions as one joint with complex mechanics, and because half of the rotational motion in the cervical spine occurs at the atlantoaxial junction, the joint relies disproportionately on ligamentous integrity. -, Ann Emerg Med. -, J Trauma. 8600 Rockville Pike Found inside – Page 157Assimilation of the atlas has been associated with increase in the atlantodental interval in as many as 57% of patients [34], fusions of other cervical ... The posterior atlantodental interval was significantly greater in the protrusion position (18.9 mm) than in the flat pillow position (16.2 mm) (P < 0.05). Neurologic symptoms can occur when the spinal cord or adjacent nerve roots are involved. Reference article, Radiopaedia.org. These discrepancies may be due to the different age populations described. It is the lateral head tilt, not head rotation, causing an asymmetry of the odontoid-lateral mass interspace. Moreover, authors found out that the preoperative diameter of the posterior atlantodental interval is the most important predictor of the potential for neurological recovery postoperatively.

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