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C1-C2 Fusion
Operation
Atlanto-axial fusion, Harms C1-C2 fusion, C1 lateral mass screw to C2 pars screw fusion
Indication
Fracture of odontoid peg, non-union of C2 fracture, atlanto-axial instability
Pre-Assessment
Required
Special preparation for surgery
Imaging of area, MRI and CT scan occasionally vascular studies.
Stop all blood thinning medications including aspirin, warfarin, clopidogrel.
Stop HRT and oral contraceptives. Stop some herbal medicines.
You will be advised when to stop these medications.
Admission to hospital
On day of surgery
General anesthetic
Yes
Operation position
Fracture table and Mayfield skull traction holding system
Details of operation
The patient is lying face down and a midline posterior cervical incision is required. Dissection is achieved to expose the bones of the posterior arch of C1 and C2. Careful dissection of the tissues between the lateral mass of C1 and the pars of C2 to allow placement of the C1 lateral mass screw under image intensification guidance and the C2 pars screw. These are linked with a rod system. Bone graft is applied to the prepared posterior arch structures of C1 and C2.
