Occipitalization of Atlas : A case report

Atlas is the first cervical vertebra. It does not have a body like other vertebrae. Its lateral masses forms ellipsoidal synovial joints with the condyles of the occipital bone. Rarely, it gets occipitalized, where the lateral masses of the atlas vertebra the condyles of the occipital bone. In this article, a total fusion of the atlas vertebra has been reported. The knowledge of such a fusion may be of importance for radiologists, anesthesiologists, orthopedic and neurosurgeons because skeletal abnormalities at the craniocervical junction may result in sudden unexpected death. It can result in dysphagia, dysarthria or torticollis because of compression of cranial nerves. Head and neck surgeons should be aware that such an anomaly may exist without any typical symptomatic presentation, and thus, serious consequences of upper cervical spinal manipulative therapy may arise when a complete and adequate clinical assessment is missed.