• Tian-Long Wu, Jing-Yu Jia, Wei-Cai Chen, Ding-Wen He, and Xi-Gao Cheng.
• Department of Orthopaedic Surgery, The Second Affiliated Hospital to Nanchang University, Nanchang, 330006, Jiangxi, China.
• Eur Spine J. 2015 May 1;24 Suppl 4:S619-22.

IntroductionNontraumatic posterior atlantooccipital dislocation has only been rarely reported. In the current study, the authors reported an extremely rare case of nontraumatic posterior atlantooccipital dislocation associated with atlantoaxial instability.Materials And MethodsA 47-year-old female was referred with a history of neck pain for 5 years. The patient had no history of trauma. The axial rotation of range of motion of the cervical spine was severely restricted. Posterior atlantooccipital dislocation with atlantoaxial instability was confirmed through conventional radiography, computed tomography and magnetic resonance imaging. We performed realignment of the dislocation and posterior occipitocervical (C0-C2) fusion. After the surgery, the patient's symptoms improved significantly and she manifested neurological improvement.ConclusionTo our knowledge, this lesion has not been reported previously. Anomalies of upper cervical spine may have induced this instability.

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