UAB Department of Orthopaedic Surgery Professor and John D. Sherrill Chair of Orthopaedic Surgery Steven Theiss, M.D., alongside Associate Professor Sakthivel Rajaram Manoharan, M.D., former Research Fellow Logan Reed, and former Spine Fellow Jacob Lepard, M.D., published a study addressing the likeliness of safe, non-operative treatment methods for a unilateral atlanto-occipital injury.

This study was published in September in the Journal of Craniovertebral Junction & Spine (JCJS) and is titled “Unilateral atlanto-occipital injury: A case series and detailed radiographic description”.

An atlanto-occipital injury is a rare and unstable injury of the craniocervical junction, associated with high-energy trauma caused by the hyperextension of the skull, found in car accidents and intense fall victims.

The study evaluated eight patients with a mean age of 45 years old. All eight patients experienced some form of neurological trauma. Causes of this trauma included motor vehicle collision for five patients (5/8, 62.5%), falls for two patients (2/8, 25%), and assault for one patient (1/8, 12.5%). All patients had a widened condyle-C1 interval >2 mm. Three patients underwent occipitocervical fusion, one patient underwent atlantoaxial fusion, and another received subaxial fusions for other injuries. Three patients underwent no surgical intervention. All of these patients were seen at least once as an outpatient following hospital discharge. There were no delayed neurologic injuries or deaths after the performance of this study.

The study concludes that a ligament injury at the craniocervical joint functions more as a spectrum rather than a dichotomous diagnosis, which a subset of this can likely, be safely managed non-operatively.

To read more about the study and its results, click here.