All four screw fixation techniques limit motion at the C1 to 2 articulation. The addition of cable fixation improves resistance to flexion and extension for posterior transarticular screw fixation.
Excessively thick plaster and a dip-water temperature of >24 degrees C should be avoided. Splints should be cut to a proper length and not folded over. Placing the limb on a pillow during the curing process puts the limb at risk. Overwrapping of plaster in fiberglass should be delayed until the plaster is fully cured and cooled.
The choice of location of occipital fixation should be based more on the ease of use and instability pattern. The decreased stiffness of the newer small rod systems should be considered.
Energy and voltage DFTs are lowered with an implantable cardioverter defibrillator that uses a tuned waveform compared to a standard 50% tilt biphasic waveform.
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