Honored guest presentation: conception to implication: craniocervical junction database and treatment algorithm.

The earliest anatomic description of abnormalities of the “occipital vertebrae” was attributed to Meckel in 1815 by Gladstone and Erickson-Powell (20). In 1830, Charles Bell first described the clinical and pathological development of “spontaneous atlantoaxial dislocations” resulting from destruction of the transverse ligament “that holds the process of the dentata in its place” (3). After this, there were detailed anatomic and autopsy studies reported in reference to abnormalities of the craniovertebral junction (5, 18, 27, 30, 42). Classic descriptions by Gladstone and EricksonPowell (20) and Giacomini (19) pointed to the clinical implications. The significance became appreciated after the radiographic study on basilar invagination by Chamberlain in 1939 (6). Radiographic descriptions of the craniocervical abnormalities and their implications, together with the craniometric reference lines, aided in the diagnosis of craniocervical abnormalities on plain x-rays as well as with tomography (6, 12, 25, 26, 30, 31, 52).