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Anatomy
Most noticeable feature – odontoid process (derived from separation and fusion of body C1 with that of C2) rising from upper surface. Also large strong spinous process.
C2 has complex articulation with atlas: Pivotal junction with odontoid process at 2 joints – front of odontoid with anterior arch C1, back of odontoid with transverse ligament C1; flexion-extension and arthrodial (sliding) joints between corresponding articular processes.
Vignette
Atlanto-axial instability common in rheumatoid arthritis, Down’s syndrome. Full dislocation associated with hyperflexion of neck in RTAs and also eg with football spear tackle injury.
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