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Updated: Feb 13, 2026

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Additional Surgical Method Aimed to Increase Distractive Force during Occipitocervical Stabilization : Technical

Veysel Antar1, Okan Turk1

  • 1Department of Neurosurgery, Istanbul Research and Training Hospital, Istanbul, Turkey.

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|March 12, 2018
PubMed
Summary

This study presents a novel surgical technique for stabilizing the craniovertebral junction, improving C2 translaminar screw placement and reducing pullout forces. The method enhances distraction force, particularly beneficial for patients with basilar invagination and low bone density.

Keywords:
CraniovertebralScrewsSpine

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Area of Science:

  • Neurosurgery
  • Orthopedic Surgery
  • Spinal Surgery

Background:

  • Craniovertebral junction anomalies present significant surgical challenges, particularly with deformities like basilar invagination.
  • The atlantoaxial joint region is anatomically complex, involving critical neural and vascular structures, and is subject to high stress from daily movements.
  • Existing stabilization techniques require careful consideration of anatomical constraints and biomechanical forces.

Purpose of the Study:

  • To describe a modified surgical technique for craniovertebral junction stabilization.
  • To address technical difficulties in screw placement and rod fixation in the atlantoaxial region.
  • To enhance the biomechanical stability of fixation in patients with basilar invagination.

Main Methods:

  • A case report of a 53-year-old male with basilar invagination and atlantoaxial dislocation.
  • Surgical intervention involved C0-C3-C4 lateral mass and C0-C2 translaminar stabilization.
  • A modified technique involved placing lateral mass screws on the occipital plate for additional rod fixation and direct C2 translaminar screw binding.

Main Results:

  • The modified technique facilitates easier insertion of C2 translaminar screws.
  • It allows for larger screw sizes and excludes pullout forces from neck movements.
  • Median rod placement aligns with the thickest part of the occipital bone, optimizing axial loading.

Conclusions:

  • The described technique is an easily performed adjuvant to classical stabilization surgery.
  • It requires no specialized screws or rods.
  • The method may improve distraction force, especially in patients with low bone density, offering a potential solution for complex craniovertebral instability.