Traumatic atlanto-occipital dislocation in children

Paul Houle, Dennis E. McDonnell, John Vender

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


Traumatic atlanto-occipital dislocation is seen in approximately 25% of fatal pediatric trauma. This was previously considered to be a rare and fatal entity, however with improvements in resuscitation in the field, many patients who previously might have died are now evaluated in the hospital. Treatment of atlanto-occipital instability is internal fixation. Many authors have advocated supplemental external immobilization with a halo vest. However, there are several circumstances where the application of a halo vest is undesirable. Thus a method of internal fixation and fusion that is rigid enough not to require supplemental external orthosis is necessary. We present 2 cases of atlanto-occipital dislocation which were treated with Locksley intersegmental tie bar occipital cervical fusion. Both patients achieved solid fusion without supplemental halo bracing, and made complete neurologic recoveries. Traumatic atlanto-occipital dislocation is a potentially survivable injury that requires aggressive resuscitation in the field, a high index of suspicion and early definitive surgical stabilization.

Original languageEnglish (US)
Pages (from-to)193-197
Number of pages5
JournalPediatric Neurosurgery
Issue number4
StatePublished - Apr 2001


  • Atlanto-occipital dislocation
  • Cervical fusion, occipital
  • Cervical fusion, posterior

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery
  • Clinical Neurology


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