Atornillado transarticular C1/2 (técnica de Magerl)

Atlantoaxial arthrodesis is indicated in the event of instability. Clinically, instability can manifest itself as persistent pain or as myelopathy, resulting from repetitive microtrauma to the spinal cord. Conventional fusion techniques, based on the use of wires, are simple to perform but lead to considerable rates of pseudoarthrosis, particularly in patients with rheumatoid arthritis. Transarticular atlantoaxial screw fixation provides higher rates of stability and reduces the rate of pseudoarthrosis. Placement of the screws requires a detailed anatomical study, especially of the C2 pars interarticularis, through CT- or NMRi-scans. The surgical technique is rather challenging, but leads to a low rate of complications.