%0 Journal Article %T Anterior Retropharyngeal Cage Distraction and Fixation for Basilar Invagination: ¡°The Wedge Technique¡± %A Sushil Patkar %J Archive of "Neurospine". %D 2019 %R 10.14245/ns.1938172.086 %X Surgery is indicated for basilar invagination (BI) in symptomatic patients. In many patients, symptoms and signs occur due to an upward-migrated and malaligned odontoid with fixed or mobile atlantoaxial instability. Posterior distraction and fixation of the atlantoaxial joints has evolved to become the standard of care, but has some inherent morbidity. In this study, we propose that the unilateral anterior submandibular retropharyngeal approach with customized wedge-shaped titanium cages inserted into both atlantoaxial joints and anterior atlantoaxial fixation with a plate screw construct is a safer and easier option in many cases of BI %K Basilar invagination %K Atlantoaxial dislocation %K Craniovertebral anomaly %K Atlantoaxial fixation %K Vertebral artery injury %K Facetal realignment %U https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6603832/