• Shenglin Wang, Peter G Passias, Libin Cui, Gang Li, Ming Yan, Haitao Zhou, and Chao Wang.
• Orthopaedic Department, Peking University Third Hospital, 49 North Garden Street, Haidian District, Beijing 100191, China.
• Eur Spine J. 2013 Jul 1;22(7):1603-7.

IntroductionPrevious studies have reported that the alignments of the occipital-cervical and subaxial spine were closely interrelated in asymptomatic individuals; however, none have focused on a population with atlantoaxial dislocation.Material And MethodsFrom 2007 to 2011, 298 patients with atlantoaxial dislocation and atlas occipitalization were studied. Angles formed between Occiput-C2 and C2-C7 were measured. The relationship between the alignment of the occipital-cervical junction and the subaxial cervical spine was evaluated.ResultsThe range of values for the angles measured was as followed: the Occiput-C2 angles were -35.2° to 44.8°, and the C2-C7 angles were -17.4° to 77.8°. Statistically significant negative correlations were observed between the Occiput-C2 and C2-C7 angles.ConclusionAnterior dislocations of the atlas are associated with diminished lordosis or even kyphosis of the occipital-cervical junction, and result in compensatory hyperlordosis of the subaxial cervical spine, collectively presenting as a "swan neck" deformity. Atlantoaxial dislocation may influence the global cervical alignment.

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