title: C1 lateral mass screws for posterior segmental stabilization of the upper cervical spine and a new method of three-point rigid fixation of the C1-C2 complex.
abstract: OBJECTIVE
  To describe our experience with C1 lateral mass screws as part of a construct for C1-2 stabilization and report an alternate method of C1-C2 complex three-point fixation.
  
  
  METHODS
  All patients that had at least one screw placed in the lateral mass of C1 as part of a construct for stabilization of the C1-C2 complex entered this study. In selected patients who had a higher chance of nonunion an alternate construct was used: transarticular C1-C2 screws combined with C1 lateral mass screws.
  
  
  RESULTS
  Twenty-one C1 lateral mass screws were placed in 11 patients. In three patients the alternate construct was used. All patients had a demonstrable solid and stable fusion on follow-up.
  
  
  CONCLUSIONS
  C1 lateral mass screws are safe and provide immediate stability. The use of C1-C2 transarticular screws combined with C1 lateral mass screws is a feasible and also an excellent alternative for a three-point fixation of the C1-C2 complex.
authors.affiliation: Hospital Mater Dei, Belo Horizonte, Minas Gerais, Brazil. mdvilela@u.washington.edu
authors.forename: Marcelo D
authors.initials: MD
authors.lastname: Vilela
authors.forename: Charles
authors.initials: C
authors.lastname: Jermani
authors.forename: Bruno P
authors.initials: BP
authors.lastname: Braga
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D002574:Cervical Vertebrae / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008875:Middle Aged; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome