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Abstract


Transarticular screw fixation augmented with interspinous wiring technique for atlantoaxial instability was analyzed to provide immediate multidirectional rigid fixation and increase likelihood of fusion of C1-2 for atlantoaxial instability in
several
biomechanical. Studies. Transarticular screw fixation eliminates antericr poster translation at C1-2 and reduce flexion and extension movement. Interspinous wiring eliminates the residual flexion and extension movement. 13 patients with
atlantoazial
instability were operated with posterior atlantoaxial facet screws fixation augmented with aninterspinous C1-2 strut graft and posterior wire fixation technique. One patient died postoperatively from cardiac problem. All surviving patients
restored
C1-2
alignment and stability without complication due to instrumentation and osseous unions have developed even 2 cases of screw breakage developed This technique was analyzed to be superior to wiring or clamp fixation biomechanically and leads to
success
without external orthosis in several series. But precaution is needed to avoid the vertebral artery injury.

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