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.