寰枢椎不稳多采用后路手术治疗,但由于其解剖及生物力学上的特殊性,内固定方式也与下颈椎明显不同,目的是提供即刻稳定性,解除脊髓及神经压迫,促进融合.目前固定方式主要包括钢丝固定技术、椎板夹或椎板钩技术、Magerl技术、寰椎侧块螺钉技术及椎弓根钉技术、枢椎椎弓根钉、枢椎椎板螺钉、峡部螺钉等,其后又出现寰椎后弓螺钉、后弓锁定钛板、寰枢侧块关节间融合器等新技术,但各固定方式在技术及恢复上颈椎稳定性上存在优缺点,故熟悉各内固定技术并对该领域研究进展有所了解有极其重要的意义.“,”The posterior approach is the common used way for atlantoaxial instability.However,due to the anatomical and biomechanical specialties,internal fixation methods are obviously different to the counterparts of the lower cervical spine.The purpose of the atlantoaxial internal fixation is to provide immediate stability,decompress the spinal cord and nerve and increase fusion rate.Nowadays,the atlantoaxial fixation techniques include wiring,interlaminar clamps,Magerl techniques,lateral mass screws,C1 pedicle screws,C2 pedicle screws,C2 translaminar screws,C2 pars screws,C1 posterior locking plate,C1 posterior arch screws and atlantoaxial lateral mass fusion cage.However,all these methods have their own merits and demerits in terms of surgical technique and capacity to restore the stability of the upper cervical spine.Therefore,it is very important to be familiar with those internal fixation techniques to an upper cervical surgeon.