It is the lateral head tilt, not head rotation, causing an asymmetry of the odontoid-lateral mass interspace
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ObjectiveAsymmetry in odontoid-lateral mass interspace in trauma patients is a common finding that regularly leads to additional diagnostic work-up, since its dignity is not entirely clear. There is little evidence in the literature that atlantoaxial asymmetry is associated with C1–C2 instability or (sub) luxation. Asymmetry in odontoid-lateral mass interspace seems to occur occasionally in healthy individuals and patients suffering a cervical spine injury. Congenital abnormalities in odontoid-lateral mass asymmetry may mimic an atlantoaxial asymmetry. The center of C1–C2 rotation is based in the peg of dens axis; therefore, a C1–C2 rotational influence seems unlikely. So far, no study examined the influence of C0–C1–C2 tilt to an asymmetry in odontoid-lateral mass interspace.
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