A 64-year-old man presented with difficulty in swallowing immediately after he had undergone an operation to fuse the occiput to the cervical spine to correct atlantoaxial subluxation. Panel A shows a preoperative lateral plain radiograph, and Panel B, a postoperative radiograph. #Clinical #Radiology #Ortho #Occipitocervical #OccipitocervicalFusion #NEJM