Posterior C1-C2 Fusion [Neurosurgery Wiki]

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====== Posterior C1-C2 Fusion ======

Posterior C1-C2 [[fusion]] is a surgical procedure aimed at stabilizing the [[atlantoaxial]] complex (C1-C2). It is commonly performed for conditions such as [[atlantoaxial instability]], traumatic fractures, [[rheumatoid arthritis]], congenital anomalies, or tumors affecting the C1-C2 region.

===== Indications =====

- [[Atlantoaxial instability]] (e.g., rheumatoid arthritis, congenital anomalies).

- [[Odontoid fracture]]s (Type II or unstable Type III fractures)

- [[Atlanto-axial subluxation]]

- Post-traumatic instability

- Neoplasms affecting C1-C2

- Post-infectious or inflammatory conditions (e.g., [[Grisel syndrome]])

===== Surgical Techniques =====

Several techniques exist for posterior C1-C2 fusion, with the most common being:

1. [[Magerl Technique]].

2. [[Harms Technique]] 

3. [[Gallie Fusion]] 

4. [[Brooks-Jenkins Fusion]].

5. [[Goel-Harms Fusion]] 



### **Complications**
- **Vertebral artery injury** (especially in transarticular screw techniques)
- **Neurological injury** (spinal cord or nerve root damage)
- **Hardware failure** (screw loosening, rod breakage)
- **Nonunion** (fusion failure)
- **Infection** (deep wound infection, osteomyelitis)

### **Outcomes**
- High fusion rates (>90%) with modern techniques.
- Postoperative bracing is often unnecessary with screw-rod constructs.
- Improved stability and pain relief.