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Menendez, Jose A. M.D.; Wright, Neill M. M.D.

Section Editor(s): Benzel, Edward C. M.D., Guest Editor; Stewart, Todd J. M.D., Associate Editor; Schlenk, Richard P. Associate Editor

doi: 10.1227/01.NEU.0000249220.50085.E4
Diagnosis and Treatment of Cervical Spondylosis: TECHNICAL CONSIDERATIONS

INSTABILITY OF THE atlantoaxial complex may result from inflammatory, traumatic, congenital, neoplastic, or degenerative disorders and often requires surgical stabilization. Initial dorsal wiring techniques allow safe fixation but require rigid external immobilization and have been associated with high fusion failure rates. Rigid screw fixation techniques including transarticular screw fixation and C1–C2 rod-cantilever fixation offer higher fusion rates and less need for rigid immobilization but are more technically demanding. C1–C2 fixation using crossing C2 laminar screws offers rigid fixation but without the technical demands of C2 pars placement. The history and techniques of dorsal fixation of the atlantoaxial complex are reviewed, and the success rates and complications of each are discussed.

Department of Neurological Surgery, Washington University, School of Medicine, St. Louis, Missouri

Reprint requests: Neill M. Wright, M.D., Department of Neurological Surgery, Washington University, School of Medicine, 660 South Euclid Avenue, Box 8057, St. Louis, MO 63110. Email:

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