OCCIPITAL-AXIS POSTERIOR WIRING AND FUSION FOR ATLANTOAXIAL DISLOCATION ASSOCIATED WITH OCCIPITALIZATION OF THE ATLAS - TECHNICAL NOTE

The authors present their technique of occipital-axis posterior wiring and fusion for atlantoaxial dislocation associated with an occipitalized atlas. The technique consists of drilling a 3 x 1-cm horizontal groove in the occipital bone 1 cm posterior to the foramen magnum and building up a bony bridge along the posterior margin of the foramen magnum. This bony bridge is referred to as an 'artificial atlas.'' Conventional wiring and fusion is performed between the artificial atlas and the C-2 lamina, interposing a strut bone graft. Since the compression force on tightening the wire is vertical, a very high degree of stability for the occipital-C-2 complex is achieved, facilitating early mobilization without postoperative redislocation.