Management of Cranio-Cervical Injuries: C1-C2 posterior cervical fusion and decompression

Abstract The Occipitocervical junction allows for rotation and flexion-extension of the head rotation. Bony articulations between C1-C2 and the ligamentous complex are responsible for stability. Fractures or injuries to the ligamentous complex often requires operative management in order to restore stability. In this review, techniques for posterior cervical fusion and decompression are reviewed and include: fixation to C2, transarticular screw construct, screw-rod construct, occipital-cervical fusion, and posterior wiring. Complications and outcomes for each of the posterior techniques are described. While the primary focus is posterior approaches, anterior C1-C2 approach play a critical role in managing these injuries and is described briefly.