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Dingjun Hao - One of the best experts on this subject based on the ideXlab platform.
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Does Additional Bone Grafting of Atlantoaxial Joint Increase Bone Fusion Rate of Iliac Crest Autograft in Posterior Occipitocervical Fusion? Retrospective, Controlled Study with 2-Year Follow-up.
World neurosurgery, 2019Co-Authors: Jun-song Yang, Hao Chen, Lei Chu, Peng Liu, Liang Yan, Tuanjiang Liu, Fang Tian, Jia-nan Zhang, Dingjun HaoAbstract:Objective We sought to explore whether additional bone grafting of the Atlantoaxial Joint increases the bone fusion rate of iliac crest autograft in posterior occipitocervical fusion surgery. Methods From January 2012 to January 2016, a total of 78 patients who had basilar invagination with occipitalization of the atlas came to our tertiary spine center. Except for those lost to follow-up (10 cases) or who had a follow-up time Results The operations were completed successfully in all patients without intraoperative complications. Only 21 (87.5%) patients in the control group had confirmed posterior bony fusion on CT, while 24 (100%) patients in the hybrid fusion group had confirmed posterior bony fusion. There were postoperative implant-related complications in 2 patients. Both cases belonged to the control group (8.3%). Three patients (12.5%) complained of transient numbness in the posterior occipital region: 2 patients in the hybrid group and 1 patient in the control group. The mean duration to posterior occipitocervical fusion was 5.5 months in the hybrid fusion group versus 6.1 months in the control group (P = 0.757). Of note, in the hybrid fusion group, the process of Atlantoaxial Joint fusion was faster than that of posterior occipitocervical fusion (5.1 months vs. 5.5 months, P = 0.823). Conclusions Additional bone grafting of the Atlantoaxial Joint could increase the bone fusion rate of iliac crest autograft in posterior occipitocervical fusion.
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wednesday september 26 2018 7 35 am 9 00 am eposters p98 does additional bone grafting of Atlantoaxial Joint increase the bone fusion rate of iliac crest autograft in posterior occipitocervical fusion a retrospective controlled study with a two year
The Spine Journal, 2018Co-Authors: Jun-song Yang, Dingjun HaoAbstract:BACKGROUND CONTEXT Occipitocervical fusion can be utilized to correct Joint instability caused by trauma, rheumatological conditions, infection, neoplasm, or congenital conditions. Bone-graft-related complication was relatively frequent during occipitocervical fusion surgery. In previous studies, the reported fusion rates were ranged from 83.6% to 100%; and the rate of instrumentation failure after nonunion was as high as 7% during occipitocervical fusion. PURPOSE To explore whether additional bone grafting of Atlantoaxial Joint increase the bone fusion rate of iliac crest autograft in posterior occipitocervical fusion surgery. STUDY DESIGN/SETTING A retrospective, controlled study with a 2-year follow-up. PATIENT SAMPLE Between January 2014 and January 2016, a total of 48 consecutive patients underwent posterior occipitocervical fusion with a screw-rod fixation system in a tertiary spine center. OUTCOME MEASURES In the postoperatively follow up, patients underwent computed tomography (CT) scan at every interval until bone fusion was confirmed. The related complications were also recorded. METHODS In the control group, we only placed a piece of autogenous iliac corticocancellous bone between the occipital and C2 vertebral laminae for fusion. In the hybrid fusion group, besides posterior occipitocervical autograft, we additionally pack some granular bone harvested from the iliac crest into bilateral Atlantoaxial Joint. RESULTS Only a piece of autogenous iliac corticocancellous bone was placed between the occipital and C2 in 24 patients to perform posterior occipitocervical fusion. In the other 24 cases, besides posterior occipitocervical autograft, we additionally pack some granular bone harvested from the iliac crest into bilateral Atlantoaxial Joint. All patients were followed for at least 24 months. Only 21 (87.5%) patients in the control group had confirmed posterior bony fusion on CT imaging while 24 (100%) patients in the hybrid fusion group had confirmed posterior bony fusion. There were postoperative implant-related complications in 2 patients; screw loosening was visible in one case, pullout and breakage of internal fixation was observed in another case. All two cases were belong to the control group (8.3%). Mean duration to posterior occipitocervical fusion was 5.5 months in the hybrid fusion group versus 6.1 months in the control group (P=.037). Of note, in the hybrid fusion group, the process of Atlantoaxial Joint fusion was faster than that of posterior occipitocervical fusion (5.1 months vs. 5.5 months, p=.103). CONCLUSIONS Additional bone grafting of Atlantoaxial Joint could increase the bone fusion rate of iliac crest autograft and promote the process of bone fusion in posterior occipitocervical fusion.
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Wednesday, September 26, 2018 7:35 AM–9:00 AM ePosters: P98. Does additional bone grafting of Atlantoaxial Joint increase the bone fusion rate of iliac crest autograft in posterior occipitocervical fusion? A retrospective, controlled study with a two
The Spine Journal, 2018Co-Authors: Jun-song Yang, Dingjun HaoAbstract:BACKGROUND CONTEXT Occipitocervical fusion can be utilized to correct Joint instability caused by trauma, rheumatological conditions, infection, neoplasm, or congenital conditions. Bone-graft-related complication was relatively frequent during occipitocervical fusion surgery. In previous studies, the reported fusion rates were ranged from 83.6% to 100%; and the rate of instrumentation failure after nonunion was as high as 7% during occipitocervical fusion. PURPOSE To explore whether additional bone grafting of Atlantoaxial Joint increase the bone fusion rate of iliac crest autograft in posterior occipitocervical fusion surgery. STUDY DESIGN/SETTING A retrospective, controlled study with a 2-year follow-up. PATIENT SAMPLE Between January 2014 and January 2016, a total of 48 consecutive patients underwent posterior occipitocervical fusion with a screw-rod fixation system in a tertiary spine center. OUTCOME MEASURES In the postoperatively follow up, patients underwent computed tomography (CT) scan at every interval until bone fusion was confirmed. The related complications were also recorded. METHODS In the control group, we only placed a piece of autogenous iliac corticocancellous bone between the occipital and C2 vertebral laminae for fusion. In the hybrid fusion group, besides posterior occipitocervical autograft, we additionally pack some granular bone harvested from the iliac crest into bilateral Atlantoaxial Joint. RESULTS Only a piece of autogenous iliac corticocancellous bone was placed between the occipital and C2 in 24 patients to perform posterior occipitocervical fusion. In the other 24 cases, besides posterior occipitocervical autograft, we additionally pack some granular bone harvested from the iliac crest into bilateral Atlantoaxial Joint. All patients were followed for at least 24 months. Only 21 (87.5%) patients in the control group had confirmed posterior bony fusion on CT imaging while 24 (100%) patients in the hybrid fusion group had confirmed posterior bony fusion. There were postoperative implant-related complications in 2 patients; screw loosening was visible in one case, pullout and breakage of internal fixation was observed in another case. All two cases were belong to the control group (8.3%). Mean duration to posterior occipitocervical fusion was 5.5 months in the hybrid fusion group versus 6.1 months in the control group (P=.037). Of note, in the hybrid fusion group, the process of Atlantoaxial Joint fusion was faster than that of posterior occipitocervical fusion (5.1 months vs. 5.5 months, p=.103). CONCLUSIONS Additional bone grafting of Atlantoaxial Joint could increase the bone fusion rate of iliac crest autograft and promote the process of bone fusion in posterior occipitocervical fusion.
Jun-song Yang - One of the best experts on this subject based on the ideXlab platform.
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Does Additional Bone Grafting of Atlantoaxial Joint Increase Bone Fusion Rate of Iliac Crest Autograft in Posterior Occipitocervical Fusion? Retrospective, Controlled Study with 2-Year Follow-up.
World neurosurgery, 2019Co-Authors: Jun-song Yang, Hao Chen, Lei Chu, Peng Liu, Liang Yan, Tuanjiang Liu, Fang Tian, Jia-nan Zhang, Dingjun HaoAbstract:Objective We sought to explore whether additional bone grafting of the Atlantoaxial Joint increases the bone fusion rate of iliac crest autograft in posterior occipitocervical fusion surgery. Methods From January 2012 to January 2016, a total of 78 patients who had basilar invagination with occipitalization of the atlas came to our tertiary spine center. Except for those lost to follow-up (10 cases) or who had a follow-up time Results The operations were completed successfully in all patients without intraoperative complications. Only 21 (87.5%) patients in the control group had confirmed posterior bony fusion on CT, while 24 (100%) patients in the hybrid fusion group had confirmed posterior bony fusion. There were postoperative implant-related complications in 2 patients. Both cases belonged to the control group (8.3%). Three patients (12.5%) complained of transient numbness in the posterior occipital region: 2 patients in the hybrid group and 1 patient in the control group. The mean duration to posterior occipitocervical fusion was 5.5 months in the hybrid fusion group versus 6.1 months in the control group (P = 0.757). Of note, in the hybrid fusion group, the process of Atlantoaxial Joint fusion was faster than that of posterior occipitocervical fusion (5.1 months vs. 5.5 months, P = 0.823). Conclusions Additional bone grafting of the Atlantoaxial Joint could increase the bone fusion rate of iliac crest autograft in posterior occipitocervical fusion.
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wednesday september 26 2018 7 35 am 9 00 am eposters p98 does additional bone grafting of Atlantoaxial Joint increase the bone fusion rate of iliac crest autograft in posterior occipitocervical fusion a retrospective controlled study with a two year
The Spine Journal, 2018Co-Authors: Jun-song Yang, Dingjun HaoAbstract:BACKGROUND CONTEXT Occipitocervical fusion can be utilized to correct Joint instability caused by trauma, rheumatological conditions, infection, neoplasm, or congenital conditions. Bone-graft-related complication was relatively frequent during occipitocervical fusion surgery. In previous studies, the reported fusion rates were ranged from 83.6% to 100%; and the rate of instrumentation failure after nonunion was as high as 7% during occipitocervical fusion. PURPOSE To explore whether additional bone grafting of Atlantoaxial Joint increase the bone fusion rate of iliac crest autograft in posterior occipitocervical fusion surgery. STUDY DESIGN/SETTING A retrospective, controlled study with a 2-year follow-up. PATIENT SAMPLE Between January 2014 and January 2016, a total of 48 consecutive patients underwent posterior occipitocervical fusion with a screw-rod fixation system in a tertiary spine center. OUTCOME MEASURES In the postoperatively follow up, patients underwent computed tomography (CT) scan at every interval until bone fusion was confirmed. The related complications were also recorded. METHODS In the control group, we only placed a piece of autogenous iliac corticocancellous bone between the occipital and C2 vertebral laminae for fusion. In the hybrid fusion group, besides posterior occipitocervical autograft, we additionally pack some granular bone harvested from the iliac crest into bilateral Atlantoaxial Joint. RESULTS Only a piece of autogenous iliac corticocancellous bone was placed between the occipital and C2 in 24 patients to perform posterior occipitocervical fusion. In the other 24 cases, besides posterior occipitocervical autograft, we additionally pack some granular bone harvested from the iliac crest into bilateral Atlantoaxial Joint. All patients were followed for at least 24 months. Only 21 (87.5%) patients in the control group had confirmed posterior bony fusion on CT imaging while 24 (100%) patients in the hybrid fusion group had confirmed posterior bony fusion. There were postoperative implant-related complications in 2 patients; screw loosening was visible in one case, pullout and breakage of internal fixation was observed in another case. All two cases were belong to the control group (8.3%). Mean duration to posterior occipitocervical fusion was 5.5 months in the hybrid fusion group versus 6.1 months in the control group (P=.037). Of note, in the hybrid fusion group, the process of Atlantoaxial Joint fusion was faster than that of posterior occipitocervical fusion (5.1 months vs. 5.5 months, p=.103). CONCLUSIONS Additional bone grafting of Atlantoaxial Joint could increase the bone fusion rate of iliac crest autograft and promote the process of bone fusion in posterior occipitocervical fusion.
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Wednesday, September 26, 2018 7:35 AM–9:00 AM ePosters: P98. Does additional bone grafting of Atlantoaxial Joint increase the bone fusion rate of iliac crest autograft in posterior occipitocervical fusion? A retrospective, controlled study with a two
The Spine Journal, 2018Co-Authors: Jun-song Yang, Dingjun HaoAbstract:BACKGROUND CONTEXT Occipitocervical fusion can be utilized to correct Joint instability caused by trauma, rheumatological conditions, infection, neoplasm, or congenital conditions. Bone-graft-related complication was relatively frequent during occipitocervical fusion surgery. In previous studies, the reported fusion rates were ranged from 83.6% to 100%; and the rate of instrumentation failure after nonunion was as high as 7% during occipitocervical fusion. PURPOSE To explore whether additional bone grafting of Atlantoaxial Joint increase the bone fusion rate of iliac crest autograft in posterior occipitocervical fusion surgery. STUDY DESIGN/SETTING A retrospective, controlled study with a 2-year follow-up. PATIENT SAMPLE Between January 2014 and January 2016, a total of 48 consecutive patients underwent posterior occipitocervical fusion with a screw-rod fixation system in a tertiary spine center. OUTCOME MEASURES In the postoperatively follow up, patients underwent computed tomography (CT) scan at every interval until bone fusion was confirmed. The related complications were also recorded. METHODS In the control group, we only placed a piece of autogenous iliac corticocancellous bone between the occipital and C2 vertebral laminae for fusion. In the hybrid fusion group, besides posterior occipitocervical autograft, we additionally pack some granular bone harvested from the iliac crest into bilateral Atlantoaxial Joint. RESULTS Only a piece of autogenous iliac corticocancellous bone was placed between the occipital and C2 in 24 patients to perform posterior occipitocervical fusion. In the other 24 cases, besides posterior occipitocervical autograft, we additionally pack some granular bone harvested from the iliac crest into bilateral Atlantoaxial Joint. All patients were followed for at least 24 months. Only 21 (87.5%) patients in the control group had confirmed posterior bony fusion on CT imaging while 24 (100%) patients in the hybrid fusion group had confirmed posterior bony fusion. There were postoperative implant-related complications in 2 patients; screw loosening was visible in one case, pullout and breakage of internal fixation was observed in another case. All two cases were belong to the control group (8.3%). Mean duration to posterior occipitocervical fusion was 5.5 months in the hybrid fusion group versus 6.1 months in the control group (P=.037). Of note, in the hybrid fusion group, the process of Atlantoaxial Joint fusion was faster than that of posterior occipitocervical fusion (5.1 months vs. 5.5 months, p=.103). CONCLUSIONS Additional bone grafting of Atlantoaxial Joint could increase the bone fusion rate of iliac crest autograft and promote the process of bone fusion in posterior occipitocervical fusion.
Atul Goel - One of the best experts on this subject based on the ideXlab platform.
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Atlantoaxial manual realignment in a patient with traumatic Atlantoaxial Joint disruption
Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia, 2010Co-Authors: Atul Goel, Antonio Figueiredo, Shradha Maheshwari, Abhidha ShahAbstract:Abstract We report a patient with complex traumatic translatory Atlantoaxial dislocation, who we treated by Joint exposure and reduction of the dislocation by facet manipulation and subsequent plate and screw Atlantoaxial fixation. A 28-year-old male had fallen 7.6 m (25 feet), and following the fall had severe neck pain but no neurological deficit. Investigations revealed a fracture at the base of the odontoid process and posterior displacement of the entire atlas over the axis, resulting in a translatory Atlantoaxial dislocation. Head traction failed as he developed severe vertigo following its application. The patient was operated upon in a prone position. We opened the Atlantoaxial Joint and realigned the facets using distraction and manipulation techniques and secured the Joint using a plate and screw interarticular method. The patient tolerated the treatment well and was symptom-free after 28 months. Postoperative images showed good craniovertebral alignment. Although technically challenging, direct manipulation of the facets of the atlas and axis can result in excellent craniovertebral realignment.
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Atlantoaxial Joint distraction as a treatment for basilar invagination: A report of an experience with 11 cases
Neurology India, 2008Co-Authors: Atul Goel, Abhidha ShahAbstract:Objective: A novel method of treatment of basilar invagination that involves distraction of the Atlantoaxial Joint using specially designed spiked spacers is described. Bone graft that is additionally placed within the appropriately prepared Atlantoaxial Joint and posterior to the arch of atlas and lamina of C2 provides bony fusion. Materials and Methods: Between December 2002 and April 2007, 11 patients underwent the discussed method of fixation at the Department of Neurosurgery, King Edward Memorial Hospital in Mumbai, India. All 11 patients had congenital basilar invagination and the symptoms were progressive in nature. Results: The mean follow-up period was 21 months (range 8-40 months). Neurological improvement and successful distraction with Atlantoaxial stabilization and ultimate bone fusion was achieved in all the patients and was documented with dynamic radiography. There were no neurological, vascular, or infective complications. Conclusions: We conclude that the described method of Atlantoaxial Joint distraction and fixation provides an alternative treatment strategy for cases with basilar invagination. Joint distraction as a stand-alone method could provide reduction of basilar invagination and firm stabilization in such cases.
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Atlantoaxial Joint jamming as a treatment for Atlantoaxial dislocation: a preliminary report: Technical note
Journal of neurosurgery. Spine, 2007Co-Authors: Atul GoelAbstract:In this report the author describes an alternative technique of Atlantoaxial fixation that involves blocking or "jamming" of movements of the Atlantoaxial Joint. The technique involves forcible impaction of spiked titanium metal spacers and bone grafts within the distracted Atlantoaxial facet Joints. Between January 2003 and January 2006, four patients underwent this method of fixation at the Department of Neurosurgery at King Edward Memorial Hospital in Mumbai, India. All four patients had posttraumatic mobile and reducible Atlantoaxial dislocation. The mean follow-up period was 16 months (range 5-35 months). Successful Atlantoaxial stabilization along with ultimate bone fusion was achieved in all patients and was documented on dynamic radiographs. There were no neurological, vascular, or infection-associated complications. The author concludes that the described method of Atlantoaxial fixation provides an alternative treatment strategy. "Joint jamming" as a stand-alone method or in combination with other fixation methods may provide firm stabilization in cases of Atlantoaxial dislocation.
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Treatment of basilar invagination by Atlantoaxial Joint distraction and direct lateral mass fixation
Journal of neurosurgery. Spine, 2004Co-Authors: Atul GoelAbstract:Object. The author discusses the successful preliminary experience of treating selected cases of basilar invagination by performing Atlantoaxial Joint distraction, reduction of the basilar invagination, and direct lateral mass Atlantoaxial plate/screw fixation. Methods. Twenty-two patients with basilar invagination—in which the odontoid process invaginated into the foramen magnum and the tip of the odontoid process was above the Chamberlain, McRae foramen magnum, and Wackenheim clival lines—were selected to undergo surgery. In all patients fixed Atlantoaxial dislocations were documented. The 16 male and six female patients ranged in age from 8 to 50 years. A history of trauma prior to the onset of symptoms was documented in 17 patients. Following surgery, the author observed minimal-to-significant reduction of basilar invagination and alteration in other craniospinal parameters resulting in restoration of alignment of the tip of the odontoid process and the clivus and the entire craniovertebral junction i...
Christoph Ozdoba - One of the best experts on this subject based on the ideXlab platform.
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surgical approach for synovial cyst of the Atlantoaxial Joint a case report and review of the literature
Spine, 2009Co-Authors: Serge Marbacher, Anton Lukes, Istvan Vajtai, Christoph OzdobaAbstract:STUDY DESIGN: Case report and review of the literature. OBJECTIVE: We describe the first case of a synovial cyst arising from pseudarthrosis of a previous dens fracture. The literature is reviewed and etiological, diagnostic, and therapeutic options of Atlantoaxial cysts are discussed. SUMMARY OF BACKGROUND DATA: Symptomatic synovial cysts of the Atlantoaxial Joint are rare. To the authors' knowledge only 24 cases have been reported.A 60-year-old patient presented with bilateral hand numbness, quadrihyperreflexia, and gait deterioration. Magnetic resonance imaging of the cervical spine disclosed a cystic mass located at the transverse ligament of dens axis causing bulbomedullary compression. METHODS: Surgery was performed via transoral image guided approach. The ventral atlas arch, dens, transverse ligament, tectorial membrane, and the compressing cyst were removed, followed by a C0-C3 fusion. RESULTS: Two months postsurgery the patient recovered completely from the cervical myelopathy with transient remnant dysparesthesia of the finger tips. CONCLUSION: Magnetic resonance imaging findings are not specific enough to establish a preoperative diagnosis. Radical resection via image-guided transoral route followed by posterior fusion allows complete resection of the cystic lesion and results in excellent long-term decompression.
Neil R Crawford - One of the best experts on this subject based on the ideXlab platform.
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Stabilization of the Atlantoaxial Joint with C1-C3 lateral mass screw constructs: biomechanical comparison with standard technique.
Neurosurgery, 2010Co-Authors: Leonardo B C Brasiliense, Bruno C R Lazaro, Phillip M Reyes, Volker K H Sonntag, Douglas J. Fox, Neil R CrawfordAbstract:BACKGROUND: Anatomically and biomechanically, the Atlantoaxial Joint is unique compared with the remainder of the cervical spine. OBJECTIVE: To assess the in vitro stability provided by 2 C2 screw sparing techniques in a destabilized model of the Atlantoaxial Joint and compare with the gold standard system. METHODS: The 3-dimensional intervertebral motion of 7 human cadaveric cervical spine specimens was recorded stereophotogrammetrically while applying non-constraining, nondestructive pure moments during flexion-extension, left and right axial rotation, and left and right lateral bending. Each specimen was tested in the intact state, followed by destabilization (odontoidectomy) and fixation as follows: (1) C1 and C3 lateral mass screws rods with sublaminar wiring of C2 (LC1-C3 + SW), (2) C1 and C3 lateral mass screws rods with a cross-link in the C1-2 interlaminar space (LC1-C3 + CL), (3) C1 and C3 lateral mass screw rods alone (negative control), and (4) C1 lateral mass and C2 pedicle screws rods augmented with C1-2 interspinous wire and graft (LC1-PC2, control group). RESULTS: Compared with the intact spine, each instrumented state significantly stabilized range of motion and lax zone at C1-2 (P < .001,1-way repeated-measures analysis of variance). LC1-C3 + SW was equivalent to LC1-PC2 during flexion and lateral bending and superior to LC1-C3 + CL during lateral bending, while LC1-C3 + CL was equivalent to LC1-PC2 only during flexion. In all other comparisons, LC1-PC2 was superior to both techniques. CONCLUSION: From a biomechanical perspective, both C2 screw sparing techniques provided sufficient stability to be regarded as an alternative for C1-2 fixation. However, because normal motion across C2-3 is sacrificed, these constructs should be used in patients with unfavorable anatomy for standard fixations.
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Stabilization of the Atlantoaxial Joint with C1-C3 lateral mass screw constructs: biomechanical comparison with standard technique.
Neurosurgery, 2010Co-Authors: Leonardo B C Brasiliense, Bruno C R Lazaro, Phillip M Reyes, Douglas Fox, Volker K H Sonntag, Neil R CrawfordAbstract:Anatomically and biomechanically, the Atlantoaxial Joint is unique compared with the remainder of the cervical spine. To assess the in vitro stability provided by 2 C2 screw sparing techniques in a destabilized model of the Atlantoaxial Joint and compare with the gold standard system. The 3-dimensional intervertebral motion of 7 human cadaveric cervical spine specimens was recorded stereophotogrammetrically while applying nonconstraining, nondestructive pure moments during flexion-extension, left and right axial rotation, and left and right lateral bending. Each specimen was tested in the intact state, followed by destabilization (odontoidectomy) and fixation as follows: (1) C1 and C3 lateral mass screws rods with sublaminar wiring of C2 (LC1-C3 + SW), (2) C1 and C3 lateral mass screws rods with a cross-link in the C1-2 interlaminar space (LC1-C3 + CL), (3) C1 and C3 lateral mass screw rods alone (negative control), and (4) C1 lateral mass and C2 pedicle screws rods augmented with C1-2 interspinous wire and graft (LC1-PC2, control group). Compared with the intact spine, each instrumented state significantly stabilized range of motion and lax zone at C1-2 (P < .001, 1-way repeated-measures analysis of variance). LC1-C3 + SW was equivalent to LC1-PC2 during flexion and lateral bending and superior to LC1-C3 + CL during lateral bending, while LC1-C3 + CL was equivalent to LC1-PC2 only during flexion. In all other comparisons, LC1-PC2 was superior to both techniques. From a biomechanical perspective, both C2 screw sparing techniques provided sufficient stability to be regarded as an alternative for C1-2 fixation. However, because normal motion across C2-3 is sacrificed, these constructs should be used in patients with unfavorable anatomy for standard fixations.