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Central or Axial Atlantoaxial Dislocation: Redefining Instability at the Craniovertebral Junction

Atul Goel

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Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.

International Journal of Neurology and Neurosurgery 18(1):p 7-9, January – April 2026. | DOI: 10.21088/ijnns.0975.0223.18126.1

How Cite This Article:

Atul Goel. Central or Axial Atlantoaxial Dislocation: Redefining Instability at the Craniovertebral Junction. Int. J Neuro Neurosurgery. 2026; 18(1): 07-09.

Timeline

Received : February 22, 2026         Accepted : March 26, 2026          Published : April 30, 2026

Abstract

N. A.

References

  • 1.   Shah A, Vutha R, Prasad A, Goel A.Central or axial atlantoaxial dislocation and craniovertebral junction alterations: a review of 393 patients treated over 12 years. Neurosurg Focus. 2023;54(3):E13.
  • 2.   Goel A, Blaskovich S, Shah A, Prasad A, Vutha R, Shukla A. Post-Traumatic Central or Axial Atlantoaxial Dislocation Presenting with “Atypical” Symptoms-Analyzing the Role of Dynamic Imaging on the Basis of Experience with 14 Patients Treated by Atlantoaxial Fixation surgery. World Neurosurg. 2024;188:e134-e144.
  • 3.   Goel A, Vutha R, Shah A, Prasad A, Gupta A, Kumar A. Central Atlantoaxial Dislocation: Presenting Symptoms, Diagnostic Parameters, and Surgical Treatment from Reports on 15 Surgically Treated Patients. Acta Neurochir Suppl. 2023;135:265-272.
  • 4.   Goel A, Blaskovich S. Rotatory and translatory “central or axial” atlantoaxial instability - Role of dynamic imaging. J Craniovertebr Junction Spine. 2023;14(4):311-312.
  • 5.   Goel A, Shah A, Rajan S. Vertical and mobile atlanto-axial dislocation. Clinical article. J Neurosurg Spine. 2009;11(1):9-14.
  • 6.   Goel A, Shah A. Atlantoaxial facet locking: treatment by facet manipulation and fixation. Experience in 14 cases. J Neurosurg Spine. 2011;14(1):3-9.
  • 7.   Goel A, Shah A. Lateral atlantoaxial facetal dislocation in craniovertebral region tuberculosis: report of a case and analysis of an alternative treatment. Acta Neurochir (Wien). 2010;152(4):709-12.
  • 8.   Goel A, Abdel Aziz MS, Shah A, Prasad A, Vutha R, Almzeogi MA. Atlantoaxial instability in Chiari formation- an analysis based on static and dynamic head imaging in 35 patients. J Clin Neurosci. 2025; 137:111310.
  • 9.   Goel A, Sathe P, Shah A. Atlantoaxial Fixation for Basilar Invagination without Obvious Atlantoaxial Instability (Group B Basilar Invagination): Outcome Analysis of 63 Surgically Treated Cases. World Neurosurg. 2017;99:164-170.
  • 10.   Goel A. Chiari malformation – Is atlantoaxial instability the cause? Outcome analysis of 65 patients with Chiari malformation treated by atlantoaxial fixation. J Neurosurg Spine. 2015;22(2):116-127.
  • 11.   Goel A, Jadhav D, Shah A, Rai S, Dandpat S, Vutha R, Dhar A, Prasad A. Chiari 1 Formation Redefined-Clinical and Radiographic Observations in 388 Surgically Treated Patients. World Neurosurg. 2020;141:e921-e934.
  • 12.   Goel A, Jain S, Shah A. Radiological Evaluation of 510 Cases of Basilar Invagination with Evidence of Atlantoaxial Instability (Group A Basilar Invagination). World Neurosurg. 2018;110:533-543.
  • 13.   Shah A, Sathe P, Patil M, Goel A. Treatment of “idiopathic” syrinx by atlantoaxial fixation: Report of an experience with nine cases. J Craniovertebr Junction Spine. 2017;8(1):15-21.
  • 14.   Goel A. Is syringomyelia pathology or a natural protective phenomenon? J Postgrad Med. 2001;47(2):87-8.
  • 15.   Goel A, Jadhav D, Shah A, Rai S, Dandpat S, Jadhav N, Vaja T. Is C2-3 fusion an evidence of atlantoaxial instability? An analysis based on surgical treatment of seven patients. J Craniovertebr Junction Spine. 2020;11(1):46-50.
  • 16.   Shah A, Kaswa A, Jain S, Goel A. Atlantoaxial instability associated with pan cervical vertebral fusion: Report on management of 4 cases. Neurol India. 2018;66(1):147-150.
  • 17.   Goel A, Nadkarni T, Shah A, et al. Bifid Anterior and Posterior Arches of atlas; Surgical implication and analysis of 70 cases. Neurosurgery. 2015;77(2):296-305.
  • 18.   Goel A, Shah A, Rajan S. Craniovertebral instability secondary to degenerative osteoarthritis of the atlanto-axial joints: Analysis of management of 108 cases. J Neurosurg Spine. 2010;12(6):592-601.
  • 19.   Goel A, El-Ghandour NMF, Shah A, Prasad A, Vutha R, Gautam S, Vaja T, Dhar A. Craniovertebral junction degenerative arthritis- evolving understanding. J Clin Neurosci. 2025;142:111638.
  • 20.   Goel A. Is central atlantoaxial instability the nodal point of pathogenesis of “idiopathic” dorsal spinal kyphoscoliosis? J Craniovertebr Junction Spine. 2019;10(1):1-2.
  • 21.   Goel A. A Review of a New Clinical Entity of ‘Central Atlantoaxial Instability’: Expanding Horizons of Craniovertebral Junction Surgery. Neurospine. 2019 Jun;16(2):186-194.
  • 22.   Goel A. Retro-odontoid mass: An evidence of craniovertebral instability. J Craniovertebr Junction Spine. 2015;6(1):6-7.
  • 23.   Goel A, Phalke U, Cacciola F, et al. Atlantoaxial Instability and Retro-odontoid Mass—Two Case Reports. Neurol Med Chir (Tokyo).2004;44:603-606.
  • 24.   Shah A, Jain S, Kaswa A, et al. Immediate postoperative disappearance of retro-odontoid ‘pseudotumor’. World Neurosurg. 2016;91: 419-423.
  • 25.   Goel A, Kulkarni AG, Sharma P. Reduction of fixed atlantoaxial dislocation in 24 cases: technical note. J Neurosurg Spine. 2005;2(4):505-509.
  • 26.   Goel A, Desai K, Muzumdar D. Atlantoaxial fixation using plate and screw method: a report of 160 treated patients. Neurosurgery. 2002;51:1351-1357.
  • 27.   Goel A, Laheri VK. Plate and screw fixation for atlanto-axial dislocation. (Technical report). Acta Neurochir (Wien). 1994;129:47-53

Data Sharing Statement

There are no additional data available. All raw data and code are available upon request.

Funding

This research received no funding.

Author Contributions

All authors contributed significantly to the work and approve its publication.

Ethics Declaration

This article does not involve any human or animal subjects, and therefore does not require ethics approval.

Acknowledgements

We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.

Conflicts of Interest

The authors report no conflicts of interest in this work.

About this article

Cite this article

Atul Goel. Central or Axial Atlantoaxial Dislocation: Redefining Instability at the Craniovertebral Junction. Int. J Neuro Neurosurgery. 2026; 18(1): 07-09.

Licence:

Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.

Received Accepted Published
February 22, 2026 March 26, 2026 April 30, 2026
DOI: 10.21088/ijnns.0975.0223.18126.1

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Timeline

Received February 22, 2026
Accepted March 26, 2026
Published April 30, 2026

licence

Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.


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