Global Spine J 2014; 04(03): 197-210
DOI: 10.1055/s-0034-1376371
Review Article
Georg Thieme Verlag KG Stuttgart · New York

A Review of the Diagnosis and Treatment of Atlantoaxial Dislocations

Sun Y. Yang1, Anthony J. Boniello1, Caroline E. Poorman1, Andy L. Chang1, Shenglin Wang2, Peter G. Passias1
  • 1Division of Spinal Surgery, Department of Orthopaedic Surgery, NYU Medical Center Hospital for Joint Diseases, NYU School of Medicine, New York, New York, United States
  • 2Orthopaedic Department, Peking University Third Hospital, Beijing, China
Further Information

Publication History

20 August 2013

15 April 2014

Publication Date:
22 May 2014 (eFirst)


Study Design Literature review.

Objective Atlantoaxial dislocation (AAD) is a rare and potentially fatal disturbance to the normal occipital-cervical anatomy that affects some populations disproportionately, which may cause permanent neurologic deficits or sagittal deformity if not treated in a timely and appropriate manner. Currently, there is a lack of consensus among surgeons on the best approach to diagnose, characterize, and treat this condition. The objective of this review is to provide a comprehensive review of the literature to identify timely and effective diagnostic techniques and treatment modalities of AAD.

Methods This review examined all articles published concerning “atlantoaxial dislocation” or “atlantoaxial subluxation” on the PubMed database. We included 112 articles published between 1966 and 2014.

Results Results of these studies are summarized primarily as defining AAD, the normal anatomy, etiology of dislocation, clinical presentation, diagnostic techniques, classification, and recommendations for timely treatment modalities.

Conclusions The Wang Classification System provides a practical means to diagnose and treat AAD. However, future research is required to identify the most salient intervention component or combination of components that lead to the best outcomes.