Occipitocervical Fusion

  • Angelo LavanoEmail author
  • Giusy Guzzi
  • Carmelino Angelo Stroscio
  • Attilio Della Torre
  • Donatella Gabriele
  • Domenico Chirchiglia
  • Giorgio Volpentesta
Part of the Acta Neurochirurgica Supplement book series (NEUROCHIRURGICA, volume 125)


Occipitocervical fusion is a surgical technique in continuous evolution due to the innovation of devices, operative and instrumentation techniques. The aetiologies responsible for occipitocervical instability are trauma, neoplastic disease, metabolic disease or congenital disease. A variety of stabilization techniques are currently available depending on the type of patient and surgeon’s experience. Each of these techniques requires thorough knowledge of the anatomy of the craniovertebral junction.


Competing Interests

The authors declare that they have no competing interests.

Compliance with Ethical Standards

No financial support was received for this work.


  1. 1.
    Kasimatis GB, Panagiotopoulos E, Gliatis J, Tyllianakis M, Zouboulis P, Lambiris E. Complications of anterior surgery in cervical spine trauma: an overview. Clin Neurol Neurosurg. 2009;111(1):18–27.CrossRefGoogle Scholar
  2. 2.
    Baskin JJ, Dickman CA, Sonntag VKH. Occipitocervical fusion. In: Winn HR, Dacey RG, editors. Youmans neurological surgery. Philadelphia: Saunders; 2004. p. 4655–70.Google Scholar
  3. 3.
    Sonntag VK, Dickman CA. Craniocervical stabilization. Clin Neurosurg. 1993;40:243–72.PubMedGoogle Scholar
  4. 4.
    Vender JR, Rekito AJ, Harrison SJ, McDonnell DE. The evolution of posterior cervical and occipitocervical fusion and instrumentation. Neurosurg Focus. 2004;16:E9.PubMedGoogle Scholar
  5. 5.
    Hamblen DC. Occipitocervical fusion. Indications, technique and results. J Bone Joint Surg. 1967;49:33–45.CrossRefGoogle Scholar
  6. 6.
    Gallie WE. Fractures and dislocations of the cervical spine. Am J Surg. 1939;46:495–9.CrossRefGoogle Scholar
  7. 7.
    Brooks AL, Jenkins EB. Atlantoaxial arthrodesis by the wedge compression method. J Bone Joint Surg Am. 1978;60:279–89.CrossRefGoogle Scholar
  8. 8.
    Duff TA, Kahn A, Corbett JE. Surgical stabilization of cervical spinal fractures using methylmethacrylate. Technical consderations and long-term results in 52 patients. J Neurosurg. 1992;76:440–3.CrossRefGoogle Scholar
  9. 9.
    Omeis I, DeMattia JA, Hillard VH, Murali R, Das K. History of instrumentation for stabilization of subaxial cervical spine. Neurosurg Focus. 2004;16(I):E10.PubMedGoogle Scholar
  10. 10.
    Marcotte P, Dickman CA, Sonntag VHK. Posterior atlantoaxial facet screw fixation. J Neurosurg. 1993;79:234–7.CrossRefGoogle Scholar
  11. 11.
    Harms J, Melcher RP. Posterior C1–C2 fusion with polyaxial screw and rod fixation. Spine. 2001;26:2467–71.CrossRefGoogle Scholar
  12. 12.
    Matsumoto M, Chiba K, Tsuji T. Use of a titanium mesh cage for posterior atlantoaxial arthrodesis. Technical note. J Neurosurg Spine. 2002;96:127–30.CrossRefGoogle Scholar
  13. 13.
    Puttlitz CM, Melcher RP, Kleinstueck FS, Harms J, Braford DS, Lotz JC. Stability analysis of craniovertebral junction fixation techniques. J Bone Joint Surg Am. 2004;86A:561–8.CrossRefGoogle Scholar
  14. 14.
    Hsu YH, Liang ML, Yen YS, Cheng H, Huang CI, Huang WC. Use of screw-rod system in occipitocervical fixation. J Chin Med Assoc. 2009;72(1):20–8.CrossRefGoogle Scholar
  15. 15.
    Mullett JH, McCarthy P, O’Keefe D, McCabe JP. Occipital fixation: effect of inner occpital protuberance alignment on screw position. J Spinal Disord. 2001;14:504–6.CrossRefGoogle Scholar
  16. 16.
    Lee SC, Chen JF, Lee ST. Complications of fixation to the occiput—anatomical and design implications. Br J Neurosurg. 2004;18:590–7.CrossRefGoogle Scholar
  17. 17.
    Shad A, Shariff SS, Teddy PJ, Cadoux-Hudson TAD. Craniocervical fusion for rheumatoid arthritis: comparison of sublaminar wires and the lateral mass screw craniocervical fusion. Br J Neurosurg. 2002;16:483–6.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Angelo Lavano
    • 1
    Email author
  • Giusy Guzzi
    • 1
  • Carmelino Angelo Stroscio
    • 1
  • Attilio Della Torre
    • 1
  • Donatella Gabriele
    • 1
  • Domenico Chirchiglia
    • 1
  • Giorgio Volpentesta
    • 1
  1. 1.Department of NeurosurgeryMagna Graecia University of CatanzaroCatanzaroItaly

Personalised recommendations