In August 2021, I had shown a case of a patient with OC1C2 tubeculosis, where I had biopsied the right lateral mass of C1, avoiding the vertebral artery.

Recently, I had a similar patient with bilateral occipito-atlantal arthropathy and bilateral C1 lateral mass osteolytic lesions.

The video explains how I pre-planned the procedure with a contrast study in the prone position and how a simple positional trick helped me avoid the vertebral artery, which is the only structure to worry about.