Data confirm that including bicortical occipital screw placement in occipitocervical constructs in children may result in a high fusion rate but at the cost of a notable complication rate 1).
The complication rate can be quite high when performing OCF in patients with cerebral palsy, rheumatoid arthritis. Much precaution should be taken when performing this procedure on high risk patients 2).
Complications included deep wound infections (n = 2), pseudoarthrosis (n = 2), and deaths (n = 4) 3).