Atlanto-occipital dissociation
Background
- Is an unstable spine injury
- Down syndome predisposes to atlanto-occipital dislocation
Clinical Features
- Often associated w/ brain injury
Diagnosis
- Evaluate with the Powers ratio
- Ratio of BC:OA > 1 suggests anterior subluxation
- BC = distance between basion and midpoint of C2 post laminar line
- OA = Distance between opisthion and ant arch of C2
Differential Diagnosis
Vertebral fractures and dislocations types
- Cervical fractures and dislocations
- Thoracic and lumbar fractures and dislocations
Workup
Management
Prehospital Immobilization
See the NAEMSP National Guidelines for Spinal Immobilization
Hospital
- C-collar
- Consult ortho or spine as needed
Disposition
- Admit