osterior interspinous wiring, with or without halo fixation, was previously themost commonmethod of fusion of C1-2 P and is still very popular. With the increasing adaptation of screw instrumentation for more rigid fixation of the spine, other techniques have become popular. Transarticular C1-2 fusions (Magerlmethod) using a screw to cross the joint supplantedwiring due to improved fusion rates, but carried ahigher risk of injuring the vertebral artery (2). In the modern Goel/Harms technique, using screws in lateral mass of C1 and pars or pedicle of C2 has been increasingly applied due to its robust biomechanical properties and rigid stabilization in various planes (1, 3). One of the major advantages of C1 lateral mass screw fixation has been that the generous size of the lateral mass makes the technique relatively safe.