Posterior approach to axis instability

Many pathologies can cause instability of the cranio-vertebral junction (CVJ). Among the most common diseases must be considered thraumatisms, neoplasms, inflammation, but also congenital malformations. Instability of the CVJ is a potentially life-threatening condition and improper treatment can lead to severe neurological deficits as well as continuous, excruciating pain in the neck. Conservative treatments are often disappointing and surgery must always be taken in consideration when approaching instability of the CVJ, being in many cases the only therapy that can provide satisfactory results. Anterior approaches to the CVJ are usually limited to few and selected cases and posterior approach must be considered the fi rst choice to restore stability of the axial cervical spine.