ABSTRACT
Atlantoaxial instability is caused by rheumatoid arthritis, trauma, tumor, infection, and congenital disorders. Several different techniques have been described for stabilization of the C1-C2 junction. Since the first report of posterior atlantoaxial fusion for the treatment of atlantoaxial instability by Gallie in 1939 (1), various posterior wiring techniques for atlantoaxial instability have been developed to provide fixation of C1-C2 segments, including Brooks fusion, modified-Gallie techniques, and the Halifax interlaminar clamp (1-5). Since 1987 when Magerl and Seeman (6) introduced the technique of transarticular screw placement, it has become the standard procedure for posterior fusion of C1-C2. In addition, other methods, such as posterior intraarticular screw fixation (7), posterior screw-rod fixation (8), and anterior transarticular screw fixation (9), have been reported for treatment of atlantoaxial lesion. In this Chapter, the authors summarize various techniques of posterior atlantoaxial fixation and review clinical and radiological records of their patient series who have undergone posterior atlantoaxial fixation.
MCGRAW’S POSTERIOR WIRING
