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Figure 1: A 7-year old boy developed quadriparesis after sustaining a fall while running. CT scan (a) showed atlanto-axial dislocation with listhesis of C1 over C2 along with mild BI. CT scan through the joints (b) shows some degree of subsidence between C1-C2. MRI (c) showed cervico-medullary compression with significant cord changes. 3-D CT with angiogram (d and e) showed evidence of normally placed vertebral artery along with bifid C1 spine. The patient underwent a C1-2 screw placement along with spacers (f and g). Spacers were placed to correct the subsidence. Reduction was adequate and the listhesis was corrected (f)

Figure 1: A 7-year old boy developed quadriparesis after sustaining a fall while running. CT scan (a) showed atlanto-axial dislocation with listhesis of C1 over C2 along with mild BI. CT scan through the joints (b) shows some degree of subsidence between C1-C2. MRI (c) showed cervico-medullary compression with significant cord changes. 3-D CT with angiogram (d and e) showed evidence of normally placed vertebral artery along with bifid C1 spine. The patient underwent a C1-2 screw placement along with spacers (f and g). Spacers were placed to correct the subsidence. Reduction was adequate and the listhesis was corrected (f)