Atlantoaxial Fixation for Craniocervical Instability Due to Metabolic Bone Disorders in Children

  • Used for C1-C2 instability: Instability may be limited to the atlantoaxial joint, e.g., some cases of Down syndrome.
  • Instrumented fixation techniques: A number of techniques for atlantoaxial fixation are described including transarticular screw fixation and the C1 lateral mass screws and C2 pedicle screws (Harms technique) fixation techniques.
  • Semi-rigid fixation techniques: An example is the sublaminar wire and bone graft fixation.


Atlantoaxial fixation with sublaminar cables: Shown is the temporary securing devices are still in place during application and tightening of subliminal cables.
Atlantoaxial fixation with autologous bone graft and sublaminar cables completed: The cables have been tightened and secured.