Occipito-cervical fusion (OCF) is required when the junction is rendered unstable by a
variety of pathological conditions including congenital abnormalities, inflammatory diseases,
trauma, tumours and infections.
Occipito -cervical instability ,neurological deficit intractable pain,atlanto-axial
osteomyelitis ,Trauma ankylosing spondylitis , atlanto- occipital osteoarthritis.