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Figure 1: Pre-operative images. (a): MRI shows basilar invagination and related severe indentation of the neural structures by the odontoid process. (b): CT scan showing basilar invagination and hyperextension. Assimilation of the atlas can be seen. (c): CT scan image with the cut passing through the facets. Facet of C1 is in a vertical position and is located anterior to the facet of axis. The facets are in the pattern of 'spondyloptosis'. (d): 3D image showing both the facets and the hyperextension of the neck. (e): Lateral profile picture of the child having severe hyperextension of the neck. (f): Front view of the child

Figure 1: Pre-operative images. (a): MRI shows basilar invagination and related severe indentation of the neural structures by the odontoid process. (b): CT scan showing basilar invagination and hyperextension. Assimilation of the atlas can be seen. (c): CT scan image with the cut passing through the facets. Facet of C1 is in a vertical position and is located anterior to the facet of axis. The facets are in the pattern of 'spondyloptosis'. (d): 3D image showing both the facets and the hyperextension of the neck. (e): Lateral profile picture of the child having severe hyperextension of the neck. (f): Front view of the child