C1–C2 Transarticular Screw Fixation in Reducible Atlantoaxial Dislocation: A Retrospective Single-Center Experience and Review of the Literature

C1-C2 transarticular screw (TAS) fixation, proposed by Magerl and Seeman, has been deemed as gold standard for reducible atlantoaxial dislocation (AAD). Though it offers excellent fusion rates, the risks of errant screw placement with subsequent vertebral artery injury or neural injury are high. We retrospectively evaluated 40 patients undergoing C1-C2 TAS fixation for mobile AAD at our institute. They were evaluated for pain, myelopathy, neurological status, screw placement, fusion rates, radiographic outcomes, and complications. Standalone bilateral C1-C2 TAS fixation (55 %) was the most common procedure performed and radiological fusion was achieved in 96.87 % of the cases. There were no serious complications like vertebral artery or neural injury. Significant improvements in modified Japanese Orthopaedic Association (mJOA) and Neck Disability Index (NDI) scores (p < 0.001) were noted postoperatively. Rigid fixation of mobile AAD with TAS has excellent fusion rates. In experienced hands, the risk of catastrophic complications from screw placement such as vertebral artery and neural injury can be mitigated.