Atlanto-occipital articulation

Dr Craig Hacking and Dr Matthew Jarvis et al.

The atlanto-occipital articulation is comprised of a pair of condyloid synovial joints that connect the occiput (C0) to the first cervical vertebra (atlas/C1).

Each joint is comprised of two concave articular surfaces on the superior aspect of the lateral mass of atlas which articulate with a convex surface on the occipital condyle. The joint is reinforced by fibrous capsules which support each joint.

The joint capsule is innervated by the C1 nerve.

  • Variable degree of communication between the atlanto-occipital joint and the cavity between the dens (odontoid peg) and transverse ligament of the cruciform ligament
  • Third occipital condyle (condylus tertius) which may articulate with the anterior arch of the atlas, or the dens
  • Paracondylar process
  • Occipital condyle hypoplasia
  • Division of the superior articular facet of the atlas

Allows for 25o of flexion/extension and around 5o of axial rotation.

Atlanto-occipital dissociation (AOD) represents the most common cervical spine injury following motor-vehicle accident and is usually highly unstable with significant neurological morbidity.

Anatomy: Spine
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Article information

rID: 35478
System: Spine
Section: Anatomy
Synonyms or Alternate Spellings:
  • Atlanto-occipital joint

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Cases and figures

  • Figure 1: median atlanto-occipital and atlantoaxial joints (Gray's illustration)
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  • Case 1: paracondylar process
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  • Case 2: third condyle
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