In our series of 17 patients with degenerative changes of the atlantoaxial joints, we could confirm this satisfactory surgical outcome in all patients. All of the 17 patients went to solid fusion. One patient had a superficial wound infection which healed without further treatment. We have found that fixing the atlantoaxial facets bilaterally with Magerl screws is a very reliable method for creating fusion. Diagnosis is easily made by transoral AP views of the atlantoaxial segment.
Posterior fusion is a rewarding procedure with a high success rate.
However, with improved imaging techniques and greater clinical awareness of this entity, diagnosis certainly has increased with frequency in the last several years. It has been postulated that this is related to a previous episode of trauma that often cannot be identified in the patient's history. Conservative therapy consisting of immobilization, physical therapy, anti-inflammatory medications, etc. are to be considered prior to surgery. Detailed radiological studies should identify the pertinent anatomy in the region of C1 and C2. Specifically, the course of the vertebral arteries should be clearly evaluated.