Atlanto-occipital dislocation: a modern case series refining management paradigms through integration of CT and MR imaging

This case series on CT and MR evaluation of AOD re-demonstrates the importance of CT criterion in guiding diagnosis of AOD, particularly CCI, in line with existing paradigms. It challenges the current scheme of AOD management by demonstrating the successful non-operative treatment of patients with injury to the tectorial, apical, and cruciate ligaments. This suggests that patients with injury to these ligaments without clear CT findings may exist as a "Grade 1.5" AOD, where decision to treat non-operatively or fuse should be carefully considered based on neurological exam, concomitant injuries, and patient overall health.