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Neurospine. 2018 Dec;15(4):323-328. doi: 10.14245/ns.1836236.118. Epub 2018 Dec 19.

Cervical Fusion as a Protective Response to Craniovertebral Junction Instability: A Novel Concept.

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Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Parel, Mumbai, India.


The author reviews the various types of cervical fusion that are associated with instability of the craniovertebral junction. Assimilation of the atlas, C2-3 fusion, the Klippel-Feil abnormality, and pancervical fusion are amongst the more common types of bone abnormalities. It is conceptualised that these types of cervical fusion are not related to any kind of embryological dysgenesis or fault, but instead emerge due to longstanding muscle spasms of the neck in response to atlantoaxial instability. Such bone fusions could be secondary protective responses to longstanding atlantoaxial instability.


Assimilation of atlas; Atlantoaxial instability; Basilar invagination; C2–3 fusion

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