An anterior high cervical retropharyngeal approach for C1–C2 intrafacetal fusion and transarticular screw insertion

Craniovertebral instability is a significant challenge to neurosurgeons. We describe an alternative anterior high cervical retropharyngeal approach for C1–C2 intrafacetal fusion and transarticular screw insertion. We dissected 10 cadaveric specimens and fixed the atlantoaxial joint with C1–C2 intrafacetal fusion and transarticular screw insertion. We achieved good surgical exposure and fixation in all cadavers with this technique. The anterior high cervical retropharyngeal approach for C1–C2 intrafacetal fusion and transarticular screw insertion may provide an alternative fusion technique for craniovertebral fusion.