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Occipitalization of the atlas is an osseous anomaly of the craniovertebral junction. The aim of this paper is to present an anatomical variant of the fused atlas with the occipital bone and discuss similar cases described in literature. The skull of an adult male analysed in this study belonged to the cranial collection of the Department of Anatomy of the Jagiellonian University, Medical Collage. A tight bony fusion between the anterior arch of the atlas, the left portion of the posterior arch, the lateral masses of the atlas, and the occipital bone was observed. Hence, the left and right superior articular facets of the atlas were fused with the corresponding occipital condyles. The anteroposterior dimension of both inferior articular facets was the same (20 mm), while the transverse diameter of the right one was considerably smaller (12 mm). The transverse diameter of the left inferior articular facets was 17 mm. The right and the left transverse process of the atlas were normally developed, each of them contained transverse foramen, and they were not fused with the occipital bone. The circumference of the foramen magnum was minimally diminished by the osseous structures of the atlas fused to the occipital bone. The sagittal and transverse diameters of the foramen magnum (38 mm x 34 mm) were within the normal range of variation. However, the asymmetrical anatomy of the inferior articular facets of the atlas give rise to speculation that movement in the atlantoaxial joint was disturbed by assimilation with the occipital bone. (Folia Morphol 2010; 69, 3: 134–137)
This study investigates if atlanto-occipital fusion affects the size and geometrical configuration of the articular facets of the atlanto-axial joint. Morphometric analysis was performed on the male adult skull, the occipital bone of which is assimilated with the first cervical vertebrae (the atlas). The perimeter, Feret’s diameter, surface area, and circularity of the inferior articular fa-cets were measured. However, we did not observe significant bilateral differences in size of the inferior articular facets of the assimilated atlas compared to normal first cervical vertebrae. Geometrical conformation of the articular facets of the atlas and axis was assessed using a coordinate measuring machine (PMM – 12106, Leitz). The results obtained from this machine indicated that the inferior articular facets of the assimilated atlas presented asymmetrical orientation compared to the normal anatomy of the atlas. Hence, in the case of occipitalization, the gap between the articulating facets of the atlas and the axis was measured to be greater than in the normal atlanto-axial joint. Computer assisted tomography was applied to visualise the anatomical relationship between the inferior articular facets of the assimilated atlas and the corresponding facets located on the axis. In this case, radiographic examination revealed that the bilaterally articulating facets (inferior and superior) showed disproportion in their adjustment within the lateral atlanto-axial joints. Thus, we concluded that the fusion of the atlas with the occipital bone altered the geometry of the inferior articular facets of the atlas and influenced the orientation of the superior articular facets of the axis. (Folia Morphol 2010; 69, 3: 147–153)
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