Integration and Modification of the Traditional Posterior Atlantoaxial Fixation Technique: The “Hook+Screw” Fixation Technique

Posterior atlantoaxial fixation methods include many techniques from cable to screw-rod fixations. Established fixation techniques, including Gallie or Brooks, Apofix laminar clamp, Magerl screw, and atlas lateral mass screws combined with axial pedicle screw fixation, have their respective deficiencies, such as lower bone graft fusion rate and poorer biomechanical stability. To improve the biomechanical characteristics and clinical outcome of established techniques, we integrated the advantages of established techniques and developed a modified posterior atlantoaxial fixation technique, “Hook+Screw.” This chapter focuses on the biomechanical evaluation and clinical outcome of this modified posterior atlantoaxial technique.