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

Background: The optimal surgical treatment of atlanto-axial instability rem ains controversial despite the variety of modifications and supplemental te chniques currently available. Methods: We describe a modification of the Br ooks posterior wiring technique supplemented with transarticular screws for C1-C2 instability. Results: This method has been implemented in 30 patient s in our institution with no radiological failures. Conclusions: The modifi cation provides several technical advantages and potentially stronger fixat ion compared to methods currently in use.