What is atlas luxation? Death of Shanquella Robinson still a ‘mystery’

Bruno Cooke November 18, 2022
What is atlas luxation? Death of Shanquella Robinson still a ‘mystery’
Digital illustration of the bones of the neck and upper spine. Downloaded from Getty Images creative.

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Charlotte, North Carolina businesswoman Shanquella Robinson’s reported death certificate lists her cause of death as “severe spinal cord injury and atlas luxation” – meaning what, exactly?

This outlet first reported on Shanquella “Quella” Robinson’s death on November 9, 2022.

But, news of her death emerged earlier, initially on Facebook, then via Newsmaven’s Charlotte Alerts website, then on TikTok

Robinson’s family understandably want concrete answers as to what caused Quella’s death while on holiday in Cabo. Now, they reportedly have a death certificate. But what does it mean?

TikTok video upload from Jan 18, 2022 | TikTok user its.quella (Shanquella Robinson)

What is ‘atlas luxation’? Meaning explained from Shanquella Robinson’s death certificate

Queen City News has reportedly obtained Shanquella “Quella” Robinson’s death certificate, which lists her cause of death as “severe spinal cord injury and atlas luxation.”

That, the outlet explains, is “instability in the uppermost vertebrae.”

The word “luxation” refers to the dislocation of a part of the anatomy, such as a bone at a joint or the lens of the eye. Those are the examples Merriam-Webster gives. 

And the atlas (plural: atlases) is the name of the first cervical vertebra. In layman’s terms, it’s the top bone in your spine. It’s in the neck and gets its name from Atlas, the Titan in Greek mythology whose punishment is to support the globe. The atlas bone supports the head.

greek atlas statue

Understanding what atlas luxation and atlantoaxial luxation mean in anatomical terms

If “luxating” is the act of dislocating something, and the atlas is the first bone in your spine, then the meaning of “atlas luxation” is simply that the top vertebra is moved from where it’s supposed to be.

Scientific literature seems to refer to it more commonly as “atlanto-axial dislocation” or “atlantoaxial luxation.”

That’s because the second spinal vertebra is called the axis. The joint between the atlas and the axis is the atlantoaxial joint. It’s a pivot joint and allows for rotation only. If it rotates too far, it seems, that’s a case of “rotary luxation of the atlas.”

In Shanquella Robinson’s case, as Queen City News writes, the meaning of the cause of death being “atlas luxation” is that something caused the uppermost bone in her spine to move out of place.

Can it cause death?

Atlantoaxial dislocation, or atlas luxation, does not always cause death.

But, a 2014 literature review in the Global Spine Journal does describe it as a “rare and potentially fatal” problem.

If not treated properly, it can cause “permanent neurologic deficits or sagittal deformity” – that’s to do with the straightness of the spine. 

If severe atlas luxation goes without surgical treatment, the authors of the review state, it can lead to respiratory failure, neurologic symptoms and, ultimately, death. They also refer to such complications as “vertebral artery injury and respiratory distress.”

But, it’s worth pointing out that according to the above research, the vast majority of cases of atlas luxation, or atlantoaxial dislocation, do not occur as a result of trauma.

What can cause atlas luxation?

“A purely traumatic atlantoaxial dislocation in the absence of another predisposing risk factor,” reads the above report, “is extremely rare.”

Most of the medical literature on atlas luxation has to do with congenital causes such as Down syndrome, skeletal dysplasia, Goldenhar syndrome and Morquio syndrome; and inflammatory causes, such as are associated with chronic rheumatoid arthritis. 

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According to Queen City News’ reporting, the group Shanquella Robinson was staying with called the concierge for help. The concierge then called a doctor who administered CPR. 

Quella died “15 minutes after her injury,” the outlet reports. Her death certificate has a section that reportedly reads, “Was it accidental or violent?”

That answer apparently reads simply, “Yes,” meaning it’s unclear whether the atlas luxation that’s listed as Shanquella Robinson’s cause of death is believed to have been caused by an accident or violence. 

It’s in this vein, therefore, that ABC7 writes that “mystery” still surrounds the North Carolina woman’s death.

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Bruno Cooke has been a freelance journalist since 2019, primarily with GRV Media. He was an early contributor to The Focus, and has written for HITC, Groundviews and the Sheffield University newspaper – he earned his MA in Global Journalism there in 2021. He’s the Spoken Word Poetry Editor for The Friday Poem, and self-published his debut novel Reveries in 2019, which his mum called both a “fine read” and “excellent Christmas present”. Bruno has lived in China, Sri Lanka and the Philippines and likes, among other things: bicycle touring, black and white Japanese films, pub quizzes, fermentation and baklava. In 2023, Bruno will set off with his partner on a round-the-world cycle.