• Alessandro Rapisarda, Giovanni Pennisi, Nicola Montano, Giuseppe Maria Della Pepa, Luca Ricciardi, Fabio De-Giorgio, Massimiliano Visocchi, Alessandro Olivi, and Filippo Maria Polli.
• Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. Electronic address: alerapi91@gmail.com.
• World Neurosurg. 2022 Oct 1; 166: 153158153-158.

PurposeAtlantoaxial joint distraction is a key procedure for the treatment of selected patients affected by basilar invagination (BI). In recent years, several authors have reported various techniques of distraction and fixation of the C1-C2 joint using different types of intra-articular spacers, with or without posterior fixation. We review the pertinent literature and propose a feasibility study on the use of a new device for the distraction of the C1-C2 joint aimed to the descent of the dens out of the foramen magnum suggesting its application on selected cases of BI.MethodsThe GL-DTRAX Cervical Cage-SE is a cage approved by the Food and Drug Administration for distraction and fixation of subaxial cervical spine. Five adult cadaveric specimens were dissected surgically to evaluate the feasibility of DTRAX insertion inside the C1-C2 joint through a posterior approach.ResultsThe cages were uneventfully set into the C1-C2 intra-articular space of all samples without the need to sacrifice C2 nerve roots and ganglia. Postoperative cervical computed tomography scanning confirmed the correct fitting of the devices in every sample.ConclusionsThis cadaveric study highlights the feasibility of the DTRAX cage as a C1-C2 intra-articular device producing a substantial distraction of atlantoaxial complex and suggesting a possible therapeutic role in selected cases of BI.Copyright © 2022. Published by Elsevier Inc.

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