Selected Instructional Course Lectures   |    
Contemporary Posterior Occipital Fixation
Gordon H. Stock, MD1; Alexander R. Vaccaro, MD1; Andrew K. Brown, MD1; Paul A. Anderson, MD2
1 Department of Orthopaedic Surgery, Thomas Jefferson University, Rothman Institute, 925 Chestnut Street, Philadelphia, PA 19107. E-mail address for A.R. Vaccaro: alexvaccaro3@aol.com
2 Department of Orthopedic Surgery and Rehabilitation, University of Wisconsin, 600 Highland Avenue, K4/736, Madison, WI 53792. E-mail address: anderson@orthorehab.wisc.edu
View Disclosures and Other Information
The authors did not receive grants or outside funding in support of their research for or preparation of this manuscript. One or more of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. (A.R. Vaccaro is either an educational consultant or receives royalties from Synthes, EBI Spine, DePuy, Medtronic, and Stryker, and P.A. Anderson is either an educational consultant or receives royalties from Medtronic and Stryker.) No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
Printed with permission of the American Academy of Orthopaedic Surgeons. This article, as well as other lectures presented at the Academy's Annual Meeting, will be available in February 2007 in Instructional Course Lectures, Volume 56. The complete volume can be ordered online at www.aaos.org, or by calling 800-626-6726 (8 a.m.-5 p.m., Central time).
An Instructional Course Lecture, American Academy of Orthopaedic Surgeons

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2006 Jul 01;88(7):1642-1649
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Throughout the spine, the vertebral bodies are separated from one another by intervertebral discs. The intervertebral discs provide strength between adjacent segments and limit movement by resisting compressive, rotational, and shear forces placed on the spine. In contrast, the highly mobile occipitocervical (atlanto-occipital and atlantoaxial) joints are synovial joints whose articulations are devoid of an intervertebral disc; instead, they are supported by capsuloligamentous attachments. This region is the most mobile portion of the cervical spine, with nearly one-half of cervical flexion-extension and cervical rotation occurring across these cartilaginous articulations. However, the anatomical structures that allow this increased mobility also predispose the joints to instability.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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