American Association of Neurological Surgeons | Mobilization of the high-riding vertebral artery for C2 screw insertion @AANSNeurosurgery | Uploaded June 2021 | Updated October 2024, 11 hours ago.
Atul Goel, MCh

Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Parel, Mumbai, India

The basic surgical steps in the Goel technique of atlantoaxial fixation involve exposure of the atlantoaxial articulation, denuding of the articular cartilage, stuffing of bone graft pieces within the articular cavity, and subsequent instrumentation.
“High-riding” vertebral artery in relationship to the pedicle-facet of C2 has been widely recognized to be a factor that makes insertion of the C2 pedicle-facet screw difficult or impossible. In this video, a technique of exposure and mobilization of the high-riding vertebral artery to permit safe C2 screw insertion is shown. An alternative option in the presence of such a high -riding vertebral artery is to use either C2 laminar or inferior facetal screw insertion.

10.3171/2020.4.FocusVid.20172



**Intro music: "Daybreak" by Graeme Rosner