Anterior screw fixation of C1 and C2

F. L. Vale, C. G. Paramore

Research output: Contribution to journalArticlepeer-review


The optimal management for odontoid type II fractures is controversial. Current surgical techniques allow immediate stabilization of the fracture fragment with minimal morbidity and mortality. Anterior odontoid screw fixation provides a high rate of fusion with preservation of normal motion in the C1-C2 segment. We recommend anterior odontoid screw placement for fractures that are displaced >4 to 6 mm, regardless of direction, as long as the transverse atlantal ligament is preserved. Essential to the success of the technique is a body habitus that will allow an appropriate trajectory of the instrumentation during screw insertion. Under fluoroscopic guidance, a lag screw can be inserted safely to cause compression and realignment of the fracture fragment. Anterior C1-C2 transarticular screws offer an option for C1-C2 fusion when posterior techniques are contraindicated and stabilization is needed at that segment. Both surgical techniques are discussed in detail.

Original languageEnglish (US)
Pages (from-to)278-285
Number of pages8
JournalTechniques in Neurosurgery
Issue number4
StatePublished - Dec 1 1998
Externally publishedYes


  • Anterior C1-C2 transarticular fusion
  • Anterior odontoid fusion
  • Lag screw
  • Odontoid fracture

ASJC Scopus subject areas

  • Clinical Neurology


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