Basilar Invagination: Surgical Treatment by Novel Anterior Implant.

Introduction: Anterior retropharyngeal realignment, distraction, and atlantoaxial fixation are an option for the treatment of symptomatic basilar invagination (BI). The anterior implants for distraction and fixation for atlantoaxial joints are still evolving. We share our experience using a novel implant which can easily, safely, and rigidly fix both lateral masses to the body of the axis.

New entry point for C2 screw, in posterior C1-C2 fixation (Goel-Harm's technique) significantly reducing the possibility of vertebral artery injury.

Objective: To reduce the chance of vertebral artery injury in posterior C1 lateral mass and C2 pedicle/pars screw-rod fixation (Goel-Harms technique ).

Method: 49 patients, 30 males and 19 females, 12years - 82 years, underwent posterior C1-C2 fixation from February 2007 till June2013. A new entry point for the posterior C2 screw, 3mm below the midpoint of the C1-C2 joint which is directed medially and downwards into the C2 body , probably avoids the vertebral artery.