Comparison of safety and stability of C-2 pars and pedicle screws for atlantoaxial fusion: meta-analysis and review of the literature

This meta-analysis and systematic review included 38 articles comparing outcomes of vertebral artery injury, screw malposition and successful arthrodesis related to C-2 pedicle and pars screws in atlantoaxial fusion. The results demonstrated a lower risk of vertebral artery injury with pars screws (1.1% vs 1.5%), but higher rate of successful fusion with pedicle screws (98% vs 94%). Differences in clinically significant screw malpositions between groups was not observed.