Biomechanical evaluation of a novel cervical spine posterior fixation technique using C1 arch screws: An in-vitro cadaveric stu

INTRODUCTION: The complex anatomy and biomechanics of the atlanto-axial motion segment impose technical challenges in the achievement of safe and successful surgical stabilization and fusion. The coauthors have recently reported successful clinical results using a novel C1-C2 stabilization technique employing C1 multi-axial posterior arch screws (MA-PAS) in a series of 3 patients (see Fig.1a-c) where anatomical anomalies precluded the use of conventional posterior fixation techniques [1]. The technically less demanding nature of MA-PAS technique, and its possible wider application in patients with normal anatomy, led the authors to compare the biomechanical stability of MA-PAS with two established multi-point fixation techniques (Magerl-Gallie and Harms) using non-destructive and destructive testing.