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Cranio-Cervical Instability Specialists

The Metropolitan Neurosurgery Group -  - Neurosurgery

The Metropolitan Neurosurgery Group

Neurosurgery located in Silver Spring, MD

Craniocervical instability occurs when weak ligaments no longer support the joints between your head and the top two vertebrae, allowing excessive movement that can damage your nerves. The board-certified neurosurgeons at The Metropolitan Neurosurgery Group in Silver Spring, Maryland, have years of experience performing the surgery you need to treat craniocervical instability and relieve your symptoms. To learn more about your options, call the office today.

Cranio-Cervical Instability Q & A

What is Craniocervical Instability?

Craniocervical instability occurs when stretched or weakened ligaments allow excessive movement between your skull and the top two vertebrae. This condition affects the ligaments responsible for stabilizing two joints:

  • Atlanto-Occipital Joint: This is the joint between your skull and the first cervical vertebra that allows your head to move up and down.
  • Atlantoaxial Joint: This joint, which lets your head rotate, is found between your first cervical vertebra, called the atlas, and the second cervical vertebra, which is known as the axis.


Craniocervical instability commonly occurs with conditions such as:

  • Type I Chiari malformation
  • Tethered cord syndrome
  • Atlantoaxial instability
  • Rheumatoid arthritis
  • Ehlers-Danlos syndrome and other hypermobility syndromes


You can also develop craniocervical instability following a traumatic injury to your head and neck, such as a from a high impact fall, a sports injury, or a car accident.

What Symptoms Develop Due to Craniocervical Instability?

Excessive movement between your head and the upper two cervical vertebrae causes vertebral dislocation, compressed nerves, and nerve damage. You may experience a wide range of symptoms, including:

  • Neck pain
  • Headaches
  • Fatigue
  • Dizziness
  • Clumsiness
  • Muscle pain
  • Visual problems
  • Gait problems
  • Balance problems
  • Memory problems
  • Arm and leg weakness or numbness


Loose ligaments in the craniocervical joints may give you the sensation that your head is literally loose or bobbing.

How is Craniocervical Instability Treated?

Following a physical examination and diagnostic imaging such as an MRI or CT scan, your The Metropolitan Neurosurgery Group provider recommends personalized treatment. In some cases with minor ligament laxity, exercises, physical therapy, and using a cervical collar to stabilize your neck may help.

If you have severe symptoms or you’re at risk for nerve injuries, your neurosurgeon may recommend surgery to stabilize your neck. During surgery, your provider realigns the cervical vertebrae and then fuses the bones to create stability.

They use several techniques to fuse the bones, often inserting a bone graft, then using screws, rods, or plates to hold the bones in place. Over the next few months, the graft promotes bone growth between the vertebrae, so they fuse into one bone.

If you have pain or other symptoms due to craniocervical instability, call The Metropolitan Neurosurgery Group.