Limitations of TA + Hook Technique
Although the previous section showed that the TA + Hook technique is an excellent technique that provided more rigid stabilization and higher fusion rates for the treatment of atlantoaxial instability, this technique still has some limitations, including potential injury to the vertebral arteries, complete preoperation reduction of the atlantoaxial joint, and unsuitability for patients with fracture or congenital absence of the posterior arch of atlas. Based on the anatomical study of the atlantoaxial lateral masses, a lateral mass fusion cage was designed. The biomechanical study demonstrated that the C1 + C2 + Cage technique, when the posterior lamina of the atlas is absent or removed for decompression, might be a viable option for the stabilization of the atlantoaxial complex.
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