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D. Kojo Hamilton, Justin S. Smith, Charles A. Sansur, Aaron S. Dumont and Christopher I. Shaffrey

A tlantoaxial stability can be compromised as a result of degenerative disease, trauma, congenital malformations, inflammatory disease, infection, and neoplasms. Significant C1–2 subluxation is often best treated using reduction and fusion. Several different techniques have been applied to achieve C1–2 fixation and arthrodesis for instability, including posterior wiring, Brooks fusion, Gallie fusion, interlaminar clamping, and transarticular screws. 2 , 9 , 18 , 25 Brooks and Gallie fusions are traditionally performed using structural autograft and often

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Vincent C. Traynelis

to access the joint in cases of fixed unilateral C1–2 rotatory subluxation on the side of which the C-1 lateral mass is anteriorly displaced. This publication and the experience of Goel et al. 2 provide compelling data that C-2 neurectomy is well tolerated, but that has not been a universal experience. Yeom et al. prospectively studied 23 patients in which the C-2 root was transected and reported that 6 patients (26%) had occipital neuralgia at the 1-year follow-up. Two of these patients had unilateral occipital neuralgia preoperatively and suffered from

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, reduced ROM, >2 level ACDF, ligamentous injuries >3.5mm subluxation or >11° of angulation, burst fractures with retropulsion, lateral mass fractures with incongruity, delayed cervical instability, junction spanning instrumentation. Patients who are pain free, without neurologic deficit, have full ROM, radiologic evidence of a healed axis lateral mass fractures, odontoid fractures, non-displaced Jefferson fractures, <2 level ACDF, single level corpectomies, compression fractures, fractures without retropulsion, chronic discs, fully fused, asymptomatic, non

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Nitin Agarwal, Federico Angriman, Ezequiel Goldschmidt, James Zhou, Adam S. Kanter, David O. Okonkwo, Peter G. Passias, Themistocles Protopsaltis, Virginie Lafage, Renaud Lafage, Frank Schwab, Shay Bess, Christopher Ames, Justin S. Smith, Christopher I. Shaffrey, Douglas Burton, D. Kojo Hamilton and the International Spine Study Group

an analysis of adults who experienced proximal junctional vertebral fractures following deformity surgery, Watanabe et al. demonstrated that patients who experienced upper instrumented vertebral collapse and adjacent vertebral subluxation, as opposed to simple fracture of the supra-adjacent vertebra, had higher preoperative BMIs (30.5 vs 23.0, p < 0.05). 22 These types of fractures were theorized to be a result of concentrated mechanical stress on the uppermost instrumented vertebra. Moreover, upper instrumental vertebral collapse carried a higher risk of severe

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Nitin Agarwal, Federico Angriman, Ezequiel Goldschmidt, James Zhou, Adam S. Kanter, David O. Okonkwo, Peter G. Passias, Themistocles Protopsaltis, Virginie Lafage, Renaud Lafage, Frank Schwab, Shay Bess, Christopher Ames, Justin S. Smith, Christopher I. Shaffrey, Douglas Burton, D. Kojo Hamilton and the International Spine Study Group

an analysis of adults who experienced proximal junctional vertebral fractures following deformity surgery, Watanabe et al. demonstrated that patients who experienced upper instrumented vertebral collapse and adjacent vertebral subluxation, as opposed to simple fracture of the supra-adjacent vertebra, had higher preoperative BMIs (30.5 vs 23.0, p < 0.05). 22 These types of fractures were theorized to be a result of concentrated mechanical stress on the uppermost instrumented vertebra. Moreover, upper instrumental vertebral collapse carried a higher risk of severe