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Atlantoaxial instability with irreducible odontoid process is one of the challenges in spine surgery. These lesions are commonly treated through anterior transoral approach which is followed by posterior atlantoaxial fusion. However, there are still many limitations, especially cerebrospinal fluid fistula with subsequent life-threatening infection, difficulty in cases with limited opening of mouth due to temporomandibular arthritis or anomalies of naso-oropharynx. Türe et al . used the extreme lateral transatlas approach for the removal of odontoid. In this study, we applied the transatlas approach but through posterior midline incision aiming to evaluate its safety and feasibility.

Odontoidectomy through posterior midline approach followed by same sitting occipitocervical fixation: A cadaveric study