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Chapter 15: Atlantoaxial Subluxation 147
B
A
Figure 15.9 CT is an effective means of assessing implant placement because of the excellent bone definition and minor metallic artifact compared with
MRI. (A) Multiplanar reconstruction (MPR) and (B) mean intensity projection (MIP) demonstrate adequate placement of transarticular screws.
A
B
Figure 15.10 Although transarticular screws/pins are associated with a relatively low failure rate, more robust constructs have been created for stabilization.
(A) Ventrodorsal and (B) lateral views of the technique described by Sanders et al. [31], supplementing transarticular screws with screws in the transverse
processes of C1, C2 and C3 encased in reinforcement bars and PMMA. Cervical vertebral plates are another method used for ventral rigid stabilization.
