• Bin Ni, Fengjin Zhou, Qunfeng Guo, Songkai Li, Xiang Guo, and Ning Xie.
• Department of Orthopedics, Changzheng Hospital, The Second Military Medical University, 415 Fengyang Road, Huangpu, Shanghai, 200003, People's Republic of China. nibin99@sohu.com
• Eur Spine J. 2012 Jan 1;21(1):156-64.

IntroductionVarious techniques have been described for posterior atlantoaxial fusion. Sublaminar passage of the wire/cable is cumbersome with a risk of spinal cord injury. Packing morselized bone grafts into the C1-2 facet joints may be difficult and it may cause massive bleeding and neuropathic pain or posterior scalp numbness postoperatively. We introduce a modified method by using C1-2 screw-rod fixation (SRF) to compress a structural iliac bone graft between the posterior elements of C1 and C2 without supplemental wiring construct.Materials And MethodsFrom December 2006 to May 2009, 35 consecutive patients with atlantoaxial instability treated by this method were reviewed retrospectively. Clinical and radiographic history was recorded. Patients with neck pain had relieved significantly after surgery and the neurologic status was also improved greatly. Thirty-three (94.3%) patients gained bony fusion at 3 months postoperatively. No vertebral artery and spinal cord injuries were noted. There was no instrumentation failure during the observation period.ConclusionWe conclude that the C1-2 SRF with construct-compression structural bone grafting can be used for C1-2 fusion with relatively simple performance and less time-consuming in selected cases.

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