• Rainer Gumpert, Thomas Poglitsch, Renate Krassnig, Rudolf Pranzl, and Paul Puchwein.
• "Mozartpraxis", Raum für Gesundheit, Mozartgasse 4, 8010, Graz, Austria.
• Arch Orthop Trauma Surg. 2017 Sep 1; 137 (9): 1253-1259.

IntroductionRing fixation of C1 can be performed using pedicle screws and a rod in case of unstable Jefferson or lateral mass fractures of C1.Materials And MethodsIn a case series of three patients, we stabilized C1 fractures surgically using a modified technique of C1 ring fixation by using monoaxial instead of polyaxial screws. Functional outcome and pain was recorded postoperatively.ResultsIn this very small case series, we observed good results concerning pain and functional outcome. All fractures were bony healed within 13 weeks. In one case, a screw penetrated the spinal canal and had to be repositioned. A mild irritation of C2 nerve root occurred in two cases postoperatively.ConclusionC1 Ring fusion with monoaxial screws provides a good ability to reduce the fracture indirectly by the screws and the rod itself.

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