title: Instrumented reduction of a fixed C1-2 subluxation using occipital and C2/C3 fixation: A case report.
abstract: BACKGROUND
  Different strategies exist for reduction of the cervical spine. Placement of C1 lateral mass screws is a powerful technique but may be impossible in a degenerative or revision setting. We report the open, posterior-only, and instrumented reduction of a fixed C1-2 subluxation using occipital and C2/C3 fixation. The patient had rheumatoid arthritis and had undergone previous surgery of the cervical spine.
  
  
  METHODS
  We performed a retrospective chart review and focused appraisal of the literature.
  
  
  RESULTS
  Satisfactory reduction was achieved with this infrequently reported technique.
  
  
  CONCLUSIONS
  Spine surgeons may consider the described procedure a viable treatment alternative in problematic subluxations of the cervical spine. Level V.
authors.affiliation: Department of Orthopedics, George Washington University Medical Center, Washington, DC.
authors.forename: Clifton
authors.initials: C
authors.lastname: Meals
authors.affiliation: Department of Orthopedics, George Washington University Medical Center, Washington, DC.
authors.forename: Rachel
authors.initials: R
authors.lastname: Harrison
authors.affiliation: Department of Orthopedics, George Washington University Medical Center, Washington, DC.
authors.forename: Warren
authors.initials: W
authors.lastname: Yu
authors.affiliation: Department of Orthopedics, George Washington University Medical Center, Washington, DC.
authors.forename: Joseph
authors.initials: J
authors.lastname: O'Brien
keywords: Cervical spine; Instrumented; Reduction; Rheumatoid arthritis; Subluxation