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Atlantoaxial Instability, Sports Medicine

Rebecca L. Carl, MD, MSCI Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Atlantoaxial instability (AAI) is the term for increased motion at the joint between the 1st and 2nd cervical vertebrae (the atlas and the axis).

  • Congenital, inflammatory, traumatic, ...

DIAGNOSIS

Lateral cervical radiographs with flexion and extension views are used for screening. AAI is defined radiographically as an increased distance between the odontoid process and the anterior a...

TREATMENT

GENERAL MEASURES

  • Management of athletes with acute worsening of AAI symptoms

  • If worsening occurs with trauma, assume a potentially unstable injury is present until proven otherwise.

  • The cervica...

ONGOING CARE

Long-term management: 
  • Individuals who exhibit signs and symptoms should be restricted from contact sports and other activities that place stress on the neck 4[B].

  • Restriction of asymptomat...

REFERENCES

1
Cremers MJ, Bol E, de Roos F, et al. Risk of sports activities in children with Down’s syndrome and atlantoaxial instability. Lancet.  1993;342(8870):511–514.
2
Bull MJ; and Committee o...

ADDITIONAL READING

  • Torg JS, Ramsey-Emrhein JA. Suggested management guidelines for participation in collision activities with congenital, developmental, or postinjury lesions involving the cervical sp...

CLINICAL PEARLS

Athletes with radiographic evidence of AAI who are asymptomatic appear to be at low risk for experiencing acute worsening during participation in organized sports (particularly noncont...

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