Modified brooks posterior wiring technique for three-point C1-C2 arthrodesis

Background: The optimal surgical treatment of atlanto-axial instability remains controversial despite the variety of modifications and supplemental techniques currently available. Methods: We describe a modification of the Brooks posterior wiring technique supplemented with transarticular screws for C1-C2 instability. Results: This method has been implemented in 30 patients in our institution with no radiological failures. Conclusions: The modification provides several technical advantages and potentially stronger fixation compared to methods currently in use.