An occipital plate for use in an occipito-cervico-thoracic (OCT) construct is mounted to a patient's occipital bone. The occipital plate includes an elongate central section aligned with a midline of the base and a pair of angled sections that project away from the central section and include attachment assemblies for securing a rod to the occipital plate. The attachment assemblies have multi-adjustability features. At least a portion of the attachment assemblies is rotatable with respect to the base so that the rods may be coupled to the occipital plate at a variety of angles with respect to the midline. The angular adjustability may accommodate any misalignments in the rods. Additionally, the position of the attachment assemblies relative to the midline of the occipital plate is adjustable to thereby provide for medial-lateral adjustability when attaching the rods to the occipital plate as part of the OCT construct.