title: Posterior atlantoaxial fusion. A new internal fixation device.
abstract: METHODS
  Biomechanical and clinical testing of an atlantoaxial posterior fixation device.
  
  
  OBJECTIVE
  The authors tested an internal fixation device to maintain the atlas and axis in an anatomic relationship while fusion occurs. The device should also facilitate intraoperative reduction of any residual anterior atlantoaxial subluxation. The device should allow the use of cancellous rather than cortical bone graft.
  
  
  BACKGROUND
  Previous techniques of atlantoaxial fusion were not universally successful, and the quality of reduction was assessed infrequently.
  
  
  METHODS
  Biomechanical testing of the fixator and clinical use in two "problem" patients requiring atlantoaxial fusion.
  
  
  RESULTS
  Biomechanical testing indicated the device should be successful. Clinical testing was successful.
  
  
  CONCLUSIONS
  The new fixator facilitates posterior atlantoaxial fusion in an anatomical position.
authors.affiliation: Department of Orthopaedic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors.forename: M W
authors.initials: MW
authors.lastname: Fidler
authors.forename: N W
authors.initials: NW
authors.lastname: Valentine
authors.forename: A T
authors.initials: AT
authors.lastname: Rahmatalla
mesh_terms: D001268:Atlanto-Axial Joint / Q000293:injuries; D001368:Axis, Cervical Vertebra / Q000601:surgery*; D001270:Cervical Atlas / Q000601:surgery*; D002574:Cervical Vertebrae / Q000293:injuries; D005260:Female; D006801:Humans; D016268:Internal Fixators; D004204:Joint Dislocations / Q000601:surgery; D008875:Middle Aged; D009809:Odontoid Process / Q000293:injuries; D016103:Spinal Fractures / Q000601:surgery; D013123:Spinal Fusion / Q000295:instrumentation*