Abstract

C1-2 posterior cervical fusion is indicated in patients with odontoid fractures that cannot be repaired with an odontoid screw, including (1) type II odontoid fractures with atlantoaxial joint fracture, (2) type II odontoid fractures with oblique fractures in the sagittal plane that preclude odontoid screw placement, (3) type II odontoid fractures with significant irreducible displacement that may not heal with immobilization (and are too displaced to place an odontoid screw), (4) type II odontoid fractures with a Jefferson fracture, and (5) type II odontoid fractures with a ruptured transverse ligament. In addition, patients with a cervicothoracic kyphosis or a very large barrel chest may be unable to be fixated with anterior odontoid screw placement (inability to achieve the trajectory required for odontoid screw placement) and are usually treated with a posterior C1-2 stabilization procedure.

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