Surgical stabilization for traumatic occipitocervical injuries

Occipitocervical injury, formerly frequently fatal, has become increasingly well recognized in trauma patients who survive beyond the initial trauma resuscitation. Posterior surgical stabilization of the occipitocervical junction is usually required. Wiring techniques and screw-plate constructs have been used for this purpose. Wiring techniques are biomechanically weaker than screw-plate constructs, require longer periods of postoperative immobilization, and rely upon intact posterior bony structures at the C1 and C2 levels. When surgical stabilization of the occipitocervical junction is indicated, screw-plate constructs with bone graft are the preferred method.