“…In this drawing, a indicates ossiculum terminale of odontoid process, derived from proatlas ; b, odontoid process, representing original body of atlas, and c, axis, The genesis of atlanto-occipital fusion has been much discussed in the anatomic literature of the last two centuries.10 There are several possible causes responsible for bony union of the atlas with the occiput: In a small group of cases fusion is the result of a pathologic process (such as arthritis or tuberculosis) occurring in fetal or in early postnatal life (Sommer,11 Virchow,12 Le Double13). In accordance with Bézi's 14 suggestion, the condition in such cases may be designated as (patho¬ logic) synostosis of the atlas with the occiput.…”