الفهرس 
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Abstract
SUMMARY AND CONCLUSION
he placement of C1 lateral mass, C2 pedicle screw screws
provide a useful alternative method to achieve atlantoaxial
fixation.
This method achieves immediate rigid stabilization of the
atlantoaxial joint and obviates the need for halo vest
immobilization. This technique may be used in certain cases as an
alternative to occipitocervical fusion, and may also be used to
increase construct stability when occipitocervical fixation is used.
Evaluation of the course of the vertebral artery with
preoperative CT scanning and use of intraoperative fluoroscopy
or image guidance are mandatory when using this technique.
Placement of C2 screw is a technically demanding
procedure that may result in grave complications from vertebral
artery injury if improperly performed.
We thus advocate that this procedure only be performed
by surgeons who are highly experienced in the treatment of
atlantoaxial instability, and who have an intimate understanding
of the anatomy of this region.
Further biomechanical analysis of this technique should
be performed to quantify the strength of constructs employing
C1 lateral mass, C2 pedicle screws as compared with other
fixation methods.