{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T10:00:32Z","timestamp":1790589632502,"version":"4.1.0"},"reference-count":35,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T00:00:00Z","timestamp":1768608000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T00:00:00Z","timestamp":1768608000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to assess clinical and radiological outcomes of temporary occiput\u2013C2 fixation(TOC2F) as an alternative to halo-vest immobilization in unstable atlas fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>After ethics approval, 43 patients treated for C1 fractures between 2011-2018 were reviewed.Inclusion criteria were acute traumatic C1 fractures managed with TOC2F and at least two years of follow-up after implant removal. Exclusion criteria were polytrauma affecting follow-up, pathological fractures, prior cervical surgery, congenital anomalies, and incomplete data. Preoperative imaging included MRI, CT, MR angiography, and X-ray. Union was evaluated with CT at 3 and 6 months. Functional outcomes were assessed using NDI, SF-36 (MCS\/PCS), and goniometric cervical rotation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The cohort consisted of 23 patients(16 male,7 female).According to Landells classification,78.2% had type II and 21.7% type III fractures. Radiological union was achieved in all patients by 6 months, with hardware removal at a mean of 6.3 months. Cervical rotation significantly improved from 103.78\u00b0 \u00b1 12.02 at day 4 to 153.78\u00b0 \u00b1 9.29 at two years(\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05).NDI scores improved from 12.21 \u00b1 3.66 to 2.14 \u00b1 0.94(\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05).Final SF-36 MCS\/PCS scores were favorable 56.33\/56.09).No neurological deterioration occurred; one superficial wound complication was documented.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>TOC2F demonstrates potential as a viable and effective alternative for the management of unstable C1 burst fractures.This technique provides immediate postoperative stability, facilitates reliable fracture union, and allows restoration of physiological cervical motion following implant removal.The favorable functional outcomes, low complication rate, and preserved long-term mobility observed in this study suggest that temporary fixation may offer substantial advantages over halo-vest immobilization and permanent fusion in appropriately selected patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682261419050","type":"journal-article","created":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T01:22:54Z","timestamp":1768699374000},"page":"2966-2974","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Temporary Occiput\u2013C2 Fixation for Unstable Atlas Fractures: A Reliable Alternative to Halo-Vest? Minimum Two-Year Clinical Outcomes"],"prefix":"10.1177","volume":"16","author":[{"given":"Abd\u00fclhalim","family":"Akar","sequence":"first","affiliation":[{"name":"Department of Spine Surgery, Memorail \u015ei\u015fli Hospital, \u0130stanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8171-8855","authenticated-orcid":false,"given":"Muhammed Fatih","family":"Sertta\u015f","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Marmara University Training and Research Hospital, \u0130stanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8886-7538","authenticated-orcid":false,"given":"Tuna","family":"Pehli\u0307vano\u011flu","sequence":"additional","affiliation":[{"name":"Medicana Bahcelievler Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U\u011fur","family":"\u00d6zdemi\u0307r","sequence":"additional","affiliation":[{"name":"Band\u0131rma Onyedi Eyl\u00fcl University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet","family":"Aydo\u011fan","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Memorail \u015ei\u015fli Hospital, \u0130stanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,17]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.6061\/clinics\/2013(11)12"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.4103\/jcvjs.jcvjs_61_22"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000020153"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.4081\/or.2018.7834"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.5152\/jarem.2019.2223"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-020-03575-w"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2010.09.025"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/2192568217726304"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2025.124024"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.4103\/jcvjs.JCVJS_118_20"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2020.04.122"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199206000-00002"},{"issue":"7","key":"e_1_3_5_14_2","first-page":"409","article-title":"The neck disability index: a study of reliability and validity","volume":"14","author":"Vernon H","year":"1991","unstructured":"Vernon H, Mior S. 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