Surgical Treatments to Stabilize the Upper Cervical Spine

The occipitoatlantoaxial complex serves as a transitional zone between the standard vertebral joint structures and the radically different skull. The three columns of lines of forces from the lower spine change to two columns at the level of the atlas [7,10]. Nearly horizontal joints, loss of disks, and a special ligamentous fixation allow extreme head motions [3,7,10] and give the spinal cord and adjacent structures optimal protection. Instability of this region may occur as a result of accidents, degenerative diseases, and tumors affecting the atlas, the axis, and their joints alone or in any combination. The extent of destruction and the clinical symptoms make necessary differentiated radiological diagnosis followed by conservative and surgical treatment. We will report our experiences in the treatment of 24 patients between April 1985 and April 1989.