As in Gallie/Brooks-type fusion.  Sublaminar wires are placed at the first two levels of the spine (C1-C2) then a piece of bone graft laid over the lamina of the two levels.  The wire are then twisted over the bone graft to hold it in place.  Once the wires are tightened, movement between the two levels is prevented, allowing the bone graft to grow into the lamina resulting in completion of the fusion of the two levels of the spine.