Functional Role of the Superior Articular Facets of the Atlas in the Enhancement of Craniovertebral Junction Stability

Whiplash distortions of the cervical spine, occurring during the retraction phase of a rear end automobile accident, are known to cause posterior translation of the head relative to the chest and shoulders [1,2]. This anteroposterior shear produces sagittal plane rotation of the cervical spine which results in relative flexion between the occiput and the atlas (Fig. 1). This study demonstrates that there is a significant difference between the average angles of the anterior aspects and the posterior aspects of the superior facets of the atlas with respect to a horizontal (transverse) plane at P<0.01. We hypothesize that developmental variations in some individuals will allow excessive posterior translation of the head during rear end automobile accidents, and that this excessive motion may increase the risk of sustaining a whiplash-type injury for some individuals.