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Here we present the use of intraoperative O-arm-based arteriography for integration with navigation for vertebral artery localization during C1 to C3 posterior instrumentation and fusion of an unstable C2 fracture in a 54-year-old man. The patient did not experience any intraoperative VAI and was subsequently discharged with no focal neurologic deficits. Detailed in our report is our protocol and procedure for obtaining and using intraoperative angiographic images. Case report detailing O arm for intraoperative identification of verteb
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