An occipital plate may include a central section, a pair of angled sections, and attachment assemblies comprising slide members configured to move along slots in the angled sections, and posts coupled to the slide members. Each post has a first and second cross dimensions. The first cross dimension of each post is less than a first cross dimension of a slide member. The second cross dimension of each post is approximately equal to a second cross dimension of a slide member. Rods may be coupled to the occipital plate at a variety of angles with respect to a midline of the plate. The angular adjustability may accommodate any misalignments in the rods. Further, the position of the attachment assemblies relative to the midline is adjustable to thereby provide for medial-lateral adjustability when attaching the rods to the occipital plate as part of an occipito-cervico-thoracic construct.