Internal fixation for atlanto-axial instability in children.

A new and simple method for the operative treatment of atlanto-axial instability in children is described. The technique involves a metal rectangle wired in place between the occiput and cervical spine to act as an internal fixation device. Onlay bone grafts subsequently produce bony fusion. A synchronous decompression of the cervical canal can be performed and there is no need for complex or prolonged external fixation.