Goel-Harms Construct for C1-C2 Fusions in Children

  • C1 lateral mass and C2 pedicle: This is a cantilever construct consisting of C1 lateral mass screws and C2 pedicle screws. The screws anchored in C2 hold the rod, which in turn supports C1, preventing its anterior movement.
  • Rigidity similar to that with transarticular screws: This construct is feasible in some patients with contraindications to transarticular screws; it provides similar rigidity (17).
  • May augment with cables: Additional rigidity can be obtained by supplementing the construct with either sublaminar or spinous process wiring.
Goel-Harms fusion: Artist’s rendering of a C1–C2 rod-cantilever fusion (52)