Craniocervical Instability

What is Craniocervical Instability?

Craniocervical Instability (CCI) is characterized by excess movement at the atlanto-occipital joint and or the atlantoaxial joint. It is a pathological condition that encompasses different aspects of ligamentous instability and impingement and compression on the sympathetic chain and or other surrounding blood vessels in the craniocervical junction. The etiology of this instability and the hyper-flexibility of the joints and ligaments in this junction can originate from traumatic injury, congenital syndromes, inflammatory diseases, and – more commonly now – connective tissue disorders.

What are the Symptoms of CCI?

Patients with CCI can present with both neck and craniofacial pain as well as neurological symptoms including, but not limited to:
  • Headaches
  • Balance instability
  • Dizziness
  • Vertigo
Patients commonly have exacerbation of symptoms with head rotation and can often find relief from their symptoms when using a cervical collar to stabilize the neck.

How is CCI Treated?

As a last resort, after the patient has failed conservative management and has confirmed craniocervical instability with the use of dynamic diagnostic imaging, surgical intervention is indicated with a fusion at the specified levels to stop the excessive motion and prevent the compression of the surrounding nerves, arteries, and veins.

Very few surgeons have experience with treating craniocervical instability as its diagnosis is often missed as its presentation mimics other syndromes and most are not comfortable with operating in the high cervical region.


Spinal Fusion