Figure 4.

Schematic diagram showing facet joint remodeling and manipulation helping in subsequent reduction through posterior approach. (a)Locked facets of C1 over C2 (spondyloptosis) and (b) C1 lateral mass and C2 pars screws in place. (c) Shaded part of C2 superior facet is the overhanging part preventing reduction by routine maneuvers needing burring or osteotomizing composing the step of “joint remodeling.” (d) Application of forces in the direction of arrowheads obtained, namely intraoperative cervical traction and gradual neck extension to bring about reduction. (e) Application of compressive forces along the cervical rods to bring about fusion.