Occipito-Cervical Fusion for Atlanto-Axial Subluxation

ABSTRACT

The authors performed occipito-cervical(C2-3) fusion in a case of atlanto-axial subluxation caused by congenital seperation of dens. At first posterior cervical fusion(C1-2-3) with rib graft was performed, but several days after the operation C1-2 subluxation developed again with cervical cord compression syndrome. In the second operation, the occiput was included in the fusion after removal of the posterior neural arch of atlas which resulted in good reduction and marked improvement in neurologic symptoms.