Skip to main content
SpringerLink
Log in
Book cover

The Resident's Guide to Spine Surgery pp 37–48Cite as

Posterior Cervical Fusion Surgery: Occiput to C2

  • Chapter
  • First Online:

  • 1034 Accesses

Abstract

Occipitocervical fusion (OCF) is used to treat several conditions that may cause instability and neurologic compromise at the craniovertebral junction. Craniocervical instability can present with a range of signs and symptoms of myelopathy, lower cranial nerve deficits, and even headaches. There are several radiographic methods that can be utilized to assess for instability at the craniocervical junction. OCF can be accomplished using a variety of instrumentation techniques and bone grafts. The anatomy of the craniocervical junction, radiographic assessment, fusion techniques, postoperative management, and complications avoidance are reviewed in this chapter.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Ando K, Imagama S, Ito Z, Kobayashi K, Yagi H, Shinjo R, Hida T, Ito K, Ishikawa Y, Ishiguro N. Minimum 5-year follow-up results for occipitocervical fusion using the screw-rod system in craniocervical instability. Clin Spine Surg. 2017;30(5):628–32.

    Article  Google Scholar 

  2. Bambakidis NC, Feiz-Erfan I, Horn EM, Gonzalez LF, Baek S, Yüksel KZ, et al. Biomechanical comparison of occipitoatlantal screw fixation techniques. J Neurosurg Spine. 2008;8(2):143–52.

    Article  Google Scholar 

  3. Dewan MC, Godil SS, Saniya S, Mendenhall SK, Devin CJ, McGirt MJ. C2 nerve root transection during C1 lateral mass screw fixation: does it affect functionality and quality of life? Neurosurgery. 2014;74(5):475–80.

    Article  Google Scholar 

  4. Felbaum D, Spitz S, Sandhu FA. Correction of clivoaxial angle deformity in the setting of suboccipital craniectomy: technical note. J Neurosurg Spine. 2015;23(1):8–15.

    Article  Google Scholar 

  5. Foerster O. Pain pathways and the surgical treatment of pain syndromes. Berlin: Urban and Schwarzenberg; 1927.

    Google Scholar 

  6. Harms J, Melcher RP. Posterior C1-C2 fusion with polyaxial screw and rod fixation. Spine. 2001;26(22):2467–71.

    Article  CAS  Google Scholar 

  7. He B, Yan L, Xu Z, Chang Z, Hao D. The causes and treatment strategies for the postoperative complications of occipitocervical fusion: a 316 cases retrospective analysis. Eur Spine J. 2014;23(8):1720–4.

    Article  Google Scholar 

  8. Huang DG, Hao DJ, He BR, Wu QN, Liu TJ, Wang XD, et al. Posterior atlantoaxial fixation: a review of all techniques. Spine J. 2015;15(10):2271–81.

    Article  Google Scholar 

  9. Hwang SW, Gressot LV, Chern JJ, Relyea K, Jea A. Complications of occipital screw placement for occipitocervical fusion in children. J Neurosurg Pediatr. 2012;9(6):586–93.

    Article  Google Scholar 

  10. Iyer RR, Tuite GF, Meoded A, Carey CC, Rodriguez LF. A modified technique for occipitocervical fusion using compressed iliac crest allograft results in a high rate of fusion in the pediatric population. World Neurosurg. 2017;107:342–50.

    Article  Google Scholar 

  11. Hankinson TC, Anderson RCE. Craniovertebral junction abnormalities in down syndrome. Neurosurgery. 2010;66(3 Suppl):32–8.

    Article  Google Scholar 

  12. Lall R, Patel NJ, Resnick DK. A review of complications associated with craniocervical fusion surgery. Neurosurgery. 2010;67(5):1396–403.

    Article  Google Scholar 

  13. Lapsiwala SB, Anderson PA, Oza A, Resnick DK, et al. Biomechanical comparison of four C1 to 2 rigid fixative techniques: anterior transarticular, posterior transarticular, C1 to C2 pedicle, and C1 to C2 intralaminar screws. Neurosurgery. 2006;58(3):516–20.

    Article  Google Scholar 

  14. Menendez J, Wright N. Techniques of posterior C1-C2 stabilization. Neurosurgery. 2007;60(S1):103–11.

    Google Scholar 

  15. Mummaneni PV, Lu DC, Dhall SS, Mummaneni VP, Chou D. C1 lateral mass fixation: a comparison of constructs. Neurosurgery. 2010;66(S3):153–60.

    Article  Google Scholar 

  16. Nassos JT, Ghanayem AJ, Sasso RC, Tzermiadianos MN, Voronov LI, Havey RM, et al. Biomechanical evaluation of segmental occipitoatlantoaxial stabilization techniques. Spine. 2009;34(25):2740–4.

    Article  Google Scholar 

  17. Pait TG, Al-Mefty O, Boop FA, Arnautovic KI, Rahman S, Ceola W. Inside–outside technique for posterior occipitocervical spine instrumentation and stabilization: preliminary results. J Neurosrug Spine. 1999;90(1 Suppl):1–7.

    CAS  Google Scholar 

  18. Sandhu FA, Pait TG, Benzel E, Henderson FC. Occipitocervical fusion for rheumatoid arthritis using the inside-outside stabilization technique. Spine. 2003;28(4):414–9.

    PubMed  Google Scholar 

  19. Takigawa T, Simon P, Espinoza Orias AA, Hong JT, Ito Y, Inoue N, et al. Biomechanical comparison of occiput-C1-C2 fixation techniques: C0-C1 transarticular screw and direct occiput condyle screw. Spine. 2012;37(12):E696–701.

    Article  Google Scholar 

  20. Thomas JA, Tredway T, Fessler RG, Sandhu FA. An alternate method for placement of C-1 screws. J Neurosurg Spine. 2010;12(4):337–41.

    Article  Google Scholar 

  21. Winegar CD, Lawrence JP, Friel BC, Fernandez C, Hong J, Maltenfort M, et al. A systematic review of occipital cervical fusion: techniques and outcomes. J Neurosurg Spine. 2010;13(1):5–16.

    Article  Google Scholar 

  22. Wright NM. Translaminar rigid screw fixation of the axis. Technical note. J Neurosurg Spine. 2005;3(5):409–14.

    Article  Google Scholar 

  23. Young JP, Young PH, Ackermann MJ, Anderson PA, Riew KD. The ponticulus posticus: implications for screw insertion into the first cervical lateral mass. J Bone Joint Surg Am. 2005;87(11):2495–8.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, DC, USA

    R. Tushar Jha & Faheem A. Sandhu

Authors
  1. R. Tushar Jha
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Faheem A. Sandhu
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Washington Spine & Scoliosis, Institute at OrthoBethesda, Bethesda, MD, USA

    Joseph R. O'Brien

  2. Department of Orthopaedic Surgery, MedStar Georgetown University Hospital, Washington, DC, USA

    S. Bobby Kalantar

  3. Pacific Northwest University of Health Sciences, Yakima, WA, USA

    Doniel Drazin

  4. Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, DC, USA

    Faheem A. Sandhu

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Jha, R.T., Sandhu, F.A. (2020). Posterior Cervical Fusion Surgery: Occiput to C2. In: O'Brien, J., Kalantar, S., Drazin, D., Sandhu, F. (eds) The Resident's Guide to Spine Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-20847-9_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-20847-9_5

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-20846-2

  • Online ISBN: 978-3-030-20847-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation