Atlantoaxial instability (excessive movement between the first and second cervical vertebrae) can be caused by trauma, malignancy, and inflammatory or congenital defects. It can present with local pain, but if the spinal cord is compressed it can cause clumsiness, lack of coordination, difficulty walking and, rarely, paralysis or death. These interventional guidelines by NICE make recommendations on the safety and efficacy of the procedure for dealing with such patients.
The guidelines are documented as ‘ Direct C1 lateral mass screw for cervical spine stabilisation ’ , and were issued in 2005. The recommendations have been summarized as follows: Current evidence on the safety and efficacy of direct C1 lateral mass screw for cervical spine stabilisation appears adequate to support the use of this procedure, provided the normal arrangements are in place for consent, audit, and clinical…
