Basic anatomy and terminology

The atlas, otherwise known as C1, is the first cervical vertebra, the uppermost bone in the spine.

It articulates with the skull superiorly, and with the Axis, C2 inferiorly. The joint between the atlas and the skull normally allows only nodding of the head. It does not under normal circumstances allow any rotatory movement, except at the extreme of neck rotation, where it will allow up to 3-4 degrees of rotation. It is not anatomically normal for this bone to remain rotated with respect to the skull when looking straight ahead.

The atlas articulates with the skull via the occipital condyles. The atlas bone’s articulations with the skull are considerably higher at the front than at the back.

Two images of the Atlas. Note that the superior facet sits higher at the front of the neck than at the back of the neck:

While it has been commonplace within the medical profession to claim that this joint between the skull and the atlas rarely gives rise to medical problems, it is in fact very straight forwards to perform a physical examination and confirm that in  most adults it is prone to getting rotated out of place. The degree of rotation is variable, but can often be in the order of 20 degrees. It is more often rotated so that the left side of the atlas is rotated forwards. When the skull is rotated out of place on the atlas it skull sits crookedly on the neck.

Various names have been given to this phenomenon: upper cervical subluxation complex, atlas malalignment, atlas misalignment, atlanto-occipital subluxation, atlas subluxation, to name a few. For the purposes of simplicity I will refer to the problem as atlas subluxation, though what I am in fact referring to is the subluxation of the skull on the atlas. Probably the most anatomically correct name is atlanto-occipital subluxation.

A good image of the atlas and its function can be seen at this link:

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6 Responses to Basic anatomy and terminology

  1. bren says:

    i feel an urgent need to press Down on one Side of My c1 atlas. I’m wondering;,- is it “theoretically” possible to _tempoarily place a simple device -perhaps ferros (coated) to be magnetically Pulled gently down… in order to pop-out the integral tissue that …must be.. trapped between c1 & c2.
    any possiblw / potential. including mere safe access and functional placement ; and external (strong..) magnetic (highly controlable?) system. to solve my fundamental spine problem.
    Thank you very very much for your intelligent;::: informed & knowledgeable concern and interest. PLEASE contact my facebook if anyone has ANY information – obviously I’ll have to find an alternative surgeon to perform this “possible?” task. I currently have only a vague suggestion of c1-c2 fussion from Dr. Coe, Silicon valley spine…
    thak you. and please; i’m in pain, yet I’m very compassionate and empathetic person.

    • MindBody says:

      Bren,
      you need to be physically assessed by someone competent to handle the problem.
      As a rule conventional medicine does not acknowledge the problem, though some German and Belgian Orthopedic specialists do.
      As of now I feel the best fitted group to handle the problem are upper cervical chiropractors.
      Look for the site nucca.org for availbility of practitioners.
      Their techniques are ideal in that they are preceded by thorough work up, and their interventions are low impact and and low amplitude- so very safe.
      The nearest thing to what you are describing is probably the machinery used in their “atlas orthogonal” technique.

  2. adt says:

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    May be that is you! Having a look forward to peer you.

  3. Antony says:

    This is the perfect website for everyone who wants to find
    out about this topic. You know a whole lot its almost hard to argue
    with you (not that I really will need to…HaHa). You certainly put a fresh spin on a topic that has been written about for decades.
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