Atlantoaxial subluxation is uncommon in ankylosing spondylitis, especially early in the course of the disease. Two patients are described in whom atlantoaxial subluxation occurred early in the course of otherwise typical ankylosing spondylitis. The presumed mechanism is localized synovitis producing laxity or rupture of the transverse ligament. Cervical roentgenograms in maximal flexion and extension are necessary to evaluate both the degree of subluxation and the risk of cord compression.
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Sorin et al. (1979) studied this question.