{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T09:48:19Z","timestamp":1782467299611,"version":"3.54.5"},"reference-count":7,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Type II odontoid fractures are the most common unstable injuries of the upper cervical spine. They are associated with high non-union rates, particularly when accompanied by ligamentous disruption and\/or fracture displacement. Posterior C1\u2013C2 fixation using the Goel\u2013Harms technique provides immediate biomechanical stability, high fusion rates, and reduces the risk of a neurovascular injury when compared with transarticular fixation.<\/jats:p>\n <\/jats:sec>\n \n Case Description:<\/jats:title>\n A 33-year-old male sustained polytrauma after a fall from >3 m. The initial evaluation revealed a severe traumatic subarachnoid hemorrhage with additional complex craniovertebral junction instability. The cervical computed tomography and magnetic resonance imaging scans demonstrated an unstable Anderson\u2013 D\u2019Alonzo type II odontoid fracture accompanied by posterior displacement of the dens up to 5 mm into the spinal canal, occipitocervical dissociation, and rupture of the transverse and alar ligaments. Despite severe radiographic instability, no spinal cord injury was identified. Anterior odontoid screw fixation was contraindicated in this case due to the fracture morphology and extent of ligamentous disruption. Rather, we chose to perform the Goel\u2013Harms atlantoaxial stabilization technique utilizing C1 lateral mass and C2 transpedicular screw fixation. Adequate intraoperative reduction and restoration of alignment were achieved without neurovascular complications. Postoperatively, the patient remained neurologically intact, pain significantly improved, and stable fixation was achieved as documented on appropriate postoperative imaging.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n In this surgical video, the authors successfully performed Goel\u2013Harms C1 lateral mass and C2 transpedicular screw fixation to stabilize a type II odontoid fracture associated with ligamentous injury and craniovertebral instability.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_562_2026","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T09:20:53Z","timestamp":1782465653000},"page":"372","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Operative video of Goel-Harms C1-C2 fusion for atlanto-axial instability secondary to odontoid fracture (Anderson-D\u2019 Alonzo II)"],"prefix":"10.25259","volume":"17","author":[{"given":"Elizabeth","family":"Escamilla-Ch\u00e1vez","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Centro Medico ISSEMyM Toluca, Metepec, Estate of Mexico, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo Osmar","family":"Cornejo-Valencia","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Hospital Regional de Alta Especialidad del Baj\u00edo, Le\u00f3n, Guanajuato, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Oscar","family":"Ch\u00e1vez-Bejar","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Hospital Regional de Alta Especialidad del Baj\u00edo, Le\u00f3n, Guanajuato, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ximena Francesca","family":"Cuadra-Alguera","sequence":"additional","affiliation":[{"name":"Department of Ambulatory Medicine, Hospital Militar Escuela Dr. Alejandro D\u00e1vila Bola\u00f1os, Managua, Nicaragua, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Miranda-Bravo","sequence":"additional","affiliation":[{"name":"Department of Faculty of Medicine, Universidad Nacional Aut\u00f3noma de M\u00e9xico, Facultad de Estudios Superiores Iztacala, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Miranda-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Hospital Regional de Alta Especialidad del Baj\u00edo, Le\u00f3n, Guanajuato, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2026,6,26]]},"reference":[{"key":"10.25259\/SNI_562_2026\/ref-1","doi-asserted-by":"crossref","first-page":"222","DOI":"10.3171\/SPI\/2008\/8\/3\/222","article-title":"Stabilization of the atlantoaxial complex via C-1 lateral mass and C-2 pedicle screw fixation in a multicenter clinical experience in 102 patients: Modification of the harms and goel techniques","volume":"8","author":"Aryan","year":"2008","journal-title":"J Neurosurg Spine"},{"key":"10.25259\/SNI_562_2026\/ref-2","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.otsr.2013.09.019","article-title":"C1-C2 stabilization by harms arthrodesis: Indications, technique, complications and outcomes in a prospective 26-case series","volume":"100","author":"Bourdillon","year":"2014","journal-title":"Orthop Traumatol Surg Res"},{"key":"10.25259\/SNI_562_2026\/ref-3","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1007\/s00586-019-06244-2","article-title":"C1-C2 posterior screw fixation in atlantoaxial fractures revisited: Technical update based on 127 cases","volume":"29","author":"Buchmann","year":"2020","journal-title":"Eur Spine J"},{"key":"10.25259\/SNI_562_2026\/ref-4","doi-asserted-by":"crossref","first-page":"175","DOI":"10.4103\/jcvjs.jcvjs_22_22","article-title":"An experience with Goel-Harms C1-C2 fixation for type II odontoid fractures","volume":"13","author":"Jain","year":"2022","journal-title":"J Craniovertebr Junction Spine"},{"key":"10.25259\/SNI_562_2026\/ref-5","doi-asserted-by":"crossref","first-page":"6270","DOI":"10.3390\/jcm13206270","article-title":"Odontoid fractures: A review of the current state of the art","volume":"13","author":"Nouri","year":"2024","journal-title":"J Clin Med"},{"key":"10.25259\/SNI_562_2026\/ref-6","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/s41984-019-0031-1","article-title":"Surgical outcome of type II odontoid fracture, harms technique","volume":"34","author":"Saro","year":"2019","journal-title":"Egypt J Neurosurg"},{"key":"10.25259\/SNI_562_2026\/ref-7","doi-asserted-by":"crossref","first-page":"644","DOI":"10.3171\/2021.2.SPINE201645","article-title":"Posterior fusion for fragility type 2 odontoid fractures","volume":"35","author":"Traynelis","year":"2021","journal-title":"J Neurosurg Spine"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/operative-video-of-goel-harms-c1-c2-fusion-for-atlanto-axial-instability-secondary-to-odontoid-fracture-anderson-d-alonzo-ii\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/operative-video-of-goel-harms-c1-c2-fusion-for-atlanto-axial-instability-secondary-to-odontoid-fracture-anderson-d-alonzo-ii\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T09:20:54Z","timestamp":1782465654000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/operative-video-of-goel-harms-c1-c2-fusion-for-atlanto-axial-instability-secondary-to-odontoid-fracture-anderson-d-alonzo-ii\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,26]]},"references-count":7,"alternative-id":["10.25259\/SNI_562_2026"],"URL":"https:\/\/doi.org\/10.25259\/sni_562_2026","relation":{},"ISSN":["2152-7806","2229-5097"],"issn-type":[{"value":"2152-7806","type":"electronic"},{"value":"2229-5097","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6,26]]},"article-number":"372"}}