Fixation of the axis

Abstract

Objective: To review and compare the techniques of fixation of the axis vertebral segment. Also, to review the anatomy of the axis vertebrae, ligamentous attachments, and unique biomechanics of this segment.

Methods: The use of wire, cable, screw, and plate fixation techniques are reviewed and discussed in the treatment of fractures of C1 and C2 along with utilization of the halo vest and cervical collar during the postoperative period.

Results: All fixation methods were useful. However, the appropriate fixation technique is best determined by the local anatomy (eg, anomalous vertebral artery), posterior element fractures, or the necessity to remove the posterior elements for treatment of the underlying condition.

Conclusion: New techniques for fixation and instrumentation for fixation of the axis are available. Advanced imaging allows for advanced aggressive instrumentation while avoiding injury to adjacent structures. Biomechanical studies have influenced the utility and popularity of each technique.