1 Introduction top
Posterior instrumentation is either combined with open reduction, or is performed after closed reduction has been successfully achieved.
2 Reduction top
Reduction may be performed by gentle traction, especially in acute cases. If not achieved or in more delayed cases, surgical reduction is indicated.
This involves soft tissue release (ligaments, capsules and scar tissues found in delayed presentation) followed by gentle manipulation.
The final reduction must be confirmed using a C-arm.
3 Appraoch and positioning topenlarge
4 C2-C3 posterior fusion topenlarge
Polyaxial pedicle screws are inserted into C2 following the standard technique.
For fixation of C3, one of the following techniques can be applied:
The rod is placed and screws are closed with slight compression to enhance the stability of the construct.