3d x ray upper cervical spine4/13/2024 ![]() C1 fractures should be promptly identified and treated in all patients, although they rarely require surgery. ![]() Due to their high degree of motion, these bony segments are also the most often injured in adults. The occipito-atlantal and atlantoaxial articulations provide 50% of the flexion and rotation in the cervical spine, respectively. The craniocervical junction is comprised of the occiput, C1 (atlas), and C2 (axis). It behaves as an intercalated segment cradling the base of the occiput at the atlanto-occipital articulation allowing almost fifty percent of flexion-extension to occur at the neck. The atlas characteristically lacks a spinous process or vertebral body. The transverse ligament contributes the most to the C1-C2 articulation among these ligaments. The atlantoaxial joint is highly mobile and is stabilized by the anterior atlantoaxial ligament (between the anterior ring of atlas and C2), transverse ligament (posterior to odontoid process), and posterior atlantoaxial ligament (between the posterior ring of atlas and C2). ![]() The arches are joined by lateral masses on either side, whose superior and inferior articular surfaces take part in the occipito-cervical and atlantoaxial joints, respectively. It contains the anterior and posterior arches, which encircle the spinal cord (posteriorly) and the odontoid process (anteriorly). Atlas has unique anatomy in that it sits just inferior to the occiput and, through the articulations with C2 and condyles of the occipital bone, joins the skull with the cervical spine.
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