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A new fixation device for C1-C2 fusion is presented. It consists of a claw construct for the C1 arch that is rigidly attached to C1-C2 transarticular screws to form an instrument that combines anterior and posterior fixation in the same construct. The new device was successfully applied in a case with failed C1-C2 fusion that was initially stabilized with transarticular screws alone, where the usual posterior wiring was omitted due to a defect of the posterior C1 arch.

The C1 claw device: a new instrument for C1-C2 fusion