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We describe a method of internal fixation for occipito-cervical fusion utilising a standard "small fragment" T-plate bent and fixed to the skull with three screws. The lower end of the plate is screwed and wired firmly to the spine of the axis. Of 14 patients so treated, 12 fused, one died and one failed to unite to the skull. Of eight with cord signs, seven remitted or improved and one died.
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