Freehand C2 Laminar Screw Placement: Technical Note and Operative Video.

The placement of C2 laminar screws is a safe and useful method of axis fixation. The freehand method of screw placement was originally described by Wright et al., and requires detailed knowledge of the C2 posterior element anatomy, relationship to vital neurovascular structures, and technical acumen. The current evidence, surgical anatomy and technical details of screw insertion are investigated and highlighted in this manuscript and surgical video.