Conclusion: Transoropharyngeal surgical release and posterior arthrodeses can achieve satisfactory outcomes in patients with irreducible atlantoaxial dislocation.

Objective. To discuss the diagnosis, limitations, and treatment of combined occipital-cervical and atlantoaxial disassociation with normal neurologic function.

Combined injuries to both the occipital-cervical and atlantoaxial segments are less common and, to date, have only been described with severe neurologic injury.