Occipitocervical fixation

This surgical procedure aligns and stabilizes the cervical spine to correct instability at the junction of the spine and skull, which can be caused by rheumatoid arthritis, spinal tumors, and spinal trauma.

Surgical treatment of craniocervical instability usually consists of the posterior fusion of Occipital, Atlas (C1), and Axis (C2). In the Axis, pedicle screws are usually placed, though depending on the patient’s anatomy, screws can be placed in the isthmus. The Atlas screws are generally placed in the lateral masses. In regard to the fixation of the cranium to above mentioned cervical vertebrae, it can be done mainly in two ways. The most frequent and widespread way is the placement of screws in the Occipital bone. Alternatively, the cranium screws may be placed in the occipital condyle. In any of the two ways, the implanted screws are joined by lateral bars which actually are what gives rigidity to the fusion system. In most cases it is convenient to put bone graft, usually autologous, originated from the iliac crest or from the patient’s own rib. In cases where it is not possible to obtain autologous bone graft, heterologous graft (artificial bone) may also be used.