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Occipito-Cervical Fusion


Fusion of the head to vertebrae of the cervical spine. This fusion may only involve the head and upper two vertebrae (C1/C2) or can be extended to include the entire neck in some cases. The spinal cord can be decompressed at the same time. With the advance of modern C1-C2 fixation techniques, this operation has become less common. A bone graft is placed from the head down along the spine.


Atlanto-axial subluxation / instability (i.e. rheumatoid arthritis), C1/C2 instability following fractures, tumours or infection (e.g.TB)


Infection, bleeding, CSF leak, neurological damage including paralysis, stroke, no improvement of symptoms, death in cases of cervical cord injuries or injury of the vertebral arteries which supply the brain stem, failure of inserted metal work requiring further surgery. The very serious risks are small in experienced hands but nevertheless real.

Hospital stay

Depending on the underlying problem but usually 2-3 days after operation in most cases.


Always general anaesthesia


The neck might feel sore for a short time. A collar is sometimes but not routinely necessary if x-rays after the operation are satisfactory.

Commonly asked questions

How much will the operation effect my neck movements?

Occipito-cervical fusion will leave the neck and head with very little movement.

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