title: Translaminar screws in the atlas.
abstract: METHODS
  This was a retrospective review of a new surgical technique.
  
  
  OBJECTIVE
  To describe a new method of fixation augmentation in posterior C1-C2 spondylodesis.
  
  
  BACKGROUND
  Posterior atlantoaxial spondylodesis using transarticular screws is often supplemented with sublaminar wires to enhance stability. This technique is not possible if the arch of C1 is deficient. A method of stabilizing the segment and the graft was developed, and the early results were reviewed.
  
  
  METHODS
  Five patients with a deficient posterior arch of the atlas, who also needed atlantoaxial spondylodesis, were reviewed. In each patient, fixation was augmented with translaminar screws that attached the graft to the arch of C1.
  
  
  RESULTS
  In all five patients, solid arthrodesis was achieved, and all had substantial relief of pain. There were no neurologic complications or failures of fixation.
  
  
  CONCLUSIONS
  The method of fixation of graft to the atlas using translaminar screws is a safe and reasonable alternative to external halo immobilization or more extensive surgery, such as occiput to C2 fusion.
authors.affiliation: Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. timfloyd@micron.net
authors.forename: T
authors.initials: T
authors.lastname: Floyd
authors.forename: D
authors.initials: D
authors.lastname: Grob
mesh_terms: D000328:Adult; D001268:Atlanto-Axial Joint / Q000601:surgery*; D001863:Bone Screws; D016025:Bone Transplantation; D001270:Cervical Atlas / Q000601:surgery*; D005260:Female; D006801:Humans; D016268:Internal Fixators; D007593:Joint Instability / Q000601:surgery; D008875:Middle Aged; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome