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This is a surgical technique video demonstrating posterior atlantoaxial fusion (C1 lateral mass – C2 pedicle screw fixation) technique as described by Dr. Goel and Dr. Laheri, which was subsequently modified by Dr. Jurgen Harms.
Patient is a 45 year old woman with atlantoaxial instability due to Rheumatoid arthritis. She presented with intractable neck pain without myelopathy. Since the PADI (posterior atlanto-dens interval) was significantly reduced, decision was taken to perform C1-C2 fusion.
Goel A, Laheri V. Plate and screw fixation for atlanto-axial subluxation. Acta Neurochir (Wien) 1994;129:47–53.
Harms J, Melcher RP. Posterior C1-C2 fusion with polyaxial screw and rod fixation. Spine 2001;26:2467–2471.