The pathogenesis of this disease is not well understood, but is generally thought to be related to infection of the soft tissues of the neck, especially the posterior pharyngeal wall. Infection of the soft tissues of the neck spreads and infiltrates the cervical joints, causing contracture of the neck muscles and relaxation of the joint capsule, resulting in rotation or lateral displacement of the normal joint alignment and posterior displacement of the dentate process to dislocation; some scholars speculate that the mechanism is inflammatory edema, resulting in expansion of the transverse atlantoaxial ligament and instability of the atlantoaxial joint; in addition, under normal circumstances, the cervical ligaments are more relaxed in children than in adults, and the bilateral lateral small joints are in a horizontal position than in adults, resulting in The upper and lower articular surfaces are not easily and effectively restrained, and rotational displacement can easily occur. Some experts believe that once subluxation occurs, the paravertebral venous return is obstructed and soft tissue swelling in the neck is enhanced, making the protective subluxation fixed and not easily reset. Atlantoaxial subluxation can aggravate the subluxation and may even cause spinal cord injury and death by severe paralysis and respiratory arrest if it is not handled properly or if the head is subjected to minor trauma, such as rotation, sneezing, or sudden braking while riding in a car.