Abstract
1. A relatively simple method of occipito-cervical fusion using autogenous bone chips without internal fixation is described.
2. In patients with atlanto-axial subluxation posterior fusion from the occiput to the axis rather than from the atlas to the axis is more reliable and is preferred. Inclusion of the occiput adds no more than a few degrees to the restriction of movement that follows C. 1-2 fusion.
3. The indications for occipito-cervical fusion are discussed, particularly in relation to C. 1-2 instability in rheumatoid arthritis.