Atlantoaxial Stabilization

  • Avery L. Buchholz
  • John C. Quinn
  • Christopher I. ShaffreyEmail author
  • Justin S. Smith


Over the last few decades, atlantoaxial stabilization has evolved from simple posterior wiring techniques to a multitude of screw fixation points, trajectories, and constructs. Some of the earliest reports of C1 and C2 stabilization date back to 1910 when Mixter and Osgood described using heavy silk thread to tie the spinous processes together. Gallie reported on his use of C1–C2 fixation using wire in 1939. This was followed by further modifications described by Brooks and Jenkins in 1978 and Dickman and Sonntag in 1991. Interlaminar clamps were introduced in the 1980s along with C1 and C2 screw fixation techniques. These techniques have continued to evolve and will be discussed, along with the indications and variety of instrumentation options throughout this chapter.


Atlantoaxial stabilization C1–C2 fixation C1–C2 stabilization Posterior wiring Clamp fixation Transarticular screws C1–C2 segmental fixation Translaminar screw Stand-alone C2 fixation Jefferson fracture C1 lateral mass screw 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Avery L. Buchholz
    • 1
  • John C. Quinn
    • 2
  • Christopher I. Shaffrey
    • 3
    Email author
  • Justin S. Smith
    • 3
  1. 1.Department of Neurological SurgeryMedical University of South CarolinaCharlestonUSA
  2. 2.Department of NeurosurgeryUniversity of Virginia Health SystemCharlottesvilleUSA
  3. 3.Departments of Orthopaedic and Neurological SurgeryDuke University Health SystemDurhamUSA

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