- C1 lateral mass and C2 pedicle: This is a cantilever construct consisting of C1 lateral mass screws and C2 pedicle screws. The screws anchored in C2 hold the rod, which in turn supports C1, preventing its anterior movement.
- Rigidity similar to that with transarticular screws: This construct is feasible in some patients with contraindications to transarticular screws; it provides similar rigidity (17).
- May augment with cables: Additional rigidity can be obtained by supplementing the construct with either sublaminar or spinous process wiring.
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