Upper cervical spine-posterior cage reconstruction C1-C2

Abstract

Posterior cage reconstruction techniques of the atlas and axis must be tailored for the specific pathology. In this chapter, we describe the specific technique for a case of C1 reconstruction for an aneurysmal bone cyst and C2 reconstruction for metastatic breast cancer. To reconstruct the right C1, we used a Pyramesh cage filled with iliac crest graft. For the C2 lesion, we filled methyl methacrylate over Steinman pins. Both cage reconstructions were part of larger occiput to cervical lateral mass screw constructs. For these procedures, preoperative vertebral artery imaging is essential, as well as intraoperative neuromonitoring and fluoroscopy.