Abstract
Occipito-cervical (O-C) fusion is a well established bone surgery procedure. At the planning and operation of the O-C fusion, bone biology, biomechanics, and cervical alignment should all be carefully taken into consideration. In this report, I first describe the characteristics of and pitfalls to avoid in the placement of the anchors on the occiput, C1 and C2. To prevent the vascular injury, the most serious complication of the O-C fusion, a thorough understanding of the variation of the vertebral artery and cranial sinus is paramount. Precise evaluation of the individual course of each using preoperative CT angiography and CT venography is essential. The impact of the O-C2 fixation malalignment on the postoperative dysphagia, another serious complication of the O-C fusion, is also discussed.
