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and had minimum follow-up of two-years. Diagnosis, levels fused, rhBMP-2 dose, complications, and fusion (Lenke grade applied by two neuroradiologists) were assessed. Results: 53 patients (22 men/31 women) met inclusion criteria, with a mean age of 55.7 years and an average follow-up of 40 months. Surgical indications included basilar invagination (n=6), fracture (n=6), atlanto-axial instability (n=16), kyphosis/kyphoscoliosis (n=22), osteomyelitis (n=1), spondylolisthesis (n=1), cyst (n=1). 15 patients had confirmed rheumatoid disease. The average rhBMP-2

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Terrence T. Kim, Doniel Drazin, Faris Shweikeh, Robert Pashman and J. Patrick Johnson

exposure and thyroid nodules . J Res Med Sci 17 : 434 – 438 , 2012 2 Baaj AA , Beckman J , Smith DA : O-Arm-based image guidance in minimally invasive spine surgery: technical note . Clin Neurol Neurosurg 115 : 342 – 345 , 2013 3 Börm W , König RW , Albrecht A , Richter HP , Kast E : Percutaneous transarticular atlantoaxial screw fixation using a cannulated screw system and image guidance . Minim Invasive Neurosurg 47 : 111 – 114 , 2004 4 Castro WH , Halm H , Jerosch J , Malms J , Steinbeck J , Blasius S

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Doniel Drazin, Terrence T. Kim, David W. Polly Jr and J. Patrick Johnson

craniovertebral junction, atlantoaxial complex, trauma, and tumor resection. It has recently been applied in large-scale use to degenerative and congenital deformities in the thoracolumbar spine. 5 , 10 , 14 , 16 , 19 Registration The automatic registration process, a major advancement, has allowed IGS technology to be used without necessitating significant surgeon input for this part of the procedure. Previously, the registration process required obtaining a CT scan and either physically or electronically importing the data into the stereotactic IGS workstation so that

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Faris Shweikeh, Jordan P. Amadio, Monica Arnell, Zachary R. Barnard, Terrence T. Kim, J. Patrick Johnson and Doniel Drazin

basilar invagination . ORL J Otorhinolaryngol Relat Spec 72 : 91 – 95 , 2010 25 Lee JY , O'Malley BW , Newman JG , Weinstein GS , Lega B , Diaz J , : Transoral robotic surgery of craniocervical junction and atlantoaxial spine: a cadaveric study. Laboratory investigation . J Neurosurg Spine 12 : 13 – 18 , 2010 26 Lieberman IH , Togawa D , Kayanja MM , Reinhardt MK , Friedlander A , Knoller N , : Bone-mounted miniature robotic guidance for pedicle screw and translaminar facet screw placement: Part I—Technical development

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orthosis, 2 with a Minerva brace, and 1 with a halo. Two patients required cervical surgery; an occipital cervical fusion for a type 2 odontoid fracture and one atlantoaxial fusion for atlantoaxial instability was performed. At the follow up appointments, none of the patients were found to have delayed instability based on clinical examination, upright x-rays or flexion-extension x-rays. Conclusion: All isolated OCF are likely stable injuries. Our data suggests all isolated OCF may be treated conservatively with any type of cervical orthosis and minimal follow up