Atlantooccipital dislocation (AOD) or occipitoatlantal dislocation (OAD) is a rare but serious injury of the upper c-spine caused by a traumatic ligamentous disruption of the craniocervical junction. This injury usually occurs after high-energy/-velocity accidents and is associated with a high morbidity and a mortality rate of 20–30% amongst all traumatic c-spine injuries. It can be easily overlooked but needs to be considered especially after high-impact trauma and in field resuscitation. Once deemed fatal (in earlier days only 1/3 of patients reached the hospital alive), better emergency management and the widespread availability of CTs led to better on site survival and more frequent recognition and more timely diagnosis of this injury improving mortality rates and neurological outcome. This has in consequence led to an increasing incidence of this injury.
Level of Evidence II (Diagnosis)/III (Treatment)
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Level of Evidence III
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