Craniocervical instability

Craniocervical instability (CCI) is a medical condition characterized by excessive movement of the vertebra at the atlanto-occipital joint and the atlanto-axial joint located between the skull and the top two vertebra, known as C1 and C2. The condition can cause neural injury and compression of nearby structures, including the brain stem, spinal cord, vagus nerve, and vertebral artery, resulting in a constellation of symptoms.

Craniocervical instability is more common in people with a connective tissue disease, including Ehlers–Danlos syndromes, osteogenesis imperfecta, and rheumatoid arthritis. It is frequently co-morbid with atlanto-axial joint instability, Chiari malformation, or tethered spinal cord syndrome.

The condition can be brought on by physical trauma, including whiplash, laxity of the ligaments surrounding the joint, or other damage to the surrounding connective tissue.