Occipitocervical Dislocation - Everything You Need To Know - Dr. Nabil Ebraheim
Dr. Ebraheim’s educational animated video describes the Occipitocervical Dislocation.
Occipitocervical Dislocation results from disruption of the joint between the skull and the cervical spine. It is a severe injury that cause death to most victims. There will be disruption of all the ligaments and management of the patient is usually difficult. Patients who survive this injury usually have neurological deficit or can have deterioration of their neurological functions. The injury can either occur as:
•Type I: anterior displacement of the occiput.
•Type II: longitudinal distraction of the occiput from the atlas. (Avoid the use of traction).
•Type III: posterior displacement of the occiput.
Radiological interpretation:
•Basion: it is the mid-point on the anterior margin of the foramen magnum
•Opisthion: it is the mid-point on the posterior margin of the foramen magnum.
Power’s ratio: the normal ratio of BC & AO is 1
Anterior dislocation: if the ratio between BC & AO is greater than 1, an anterior occipitocervical dislocation may exist.
Treatment
•Closed reduction
•Avoid traction in type II, traction is harmful. Traction can cause neurological deficits.
•Occipitocervical fusion is done in most of the cases using plates. Knowledge of the skull anatomy including the thickness of the skull bone and location of the dural sinuses is mandatory. Placement of the screws at this EOP is more likely to injure the dural sinuses.
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