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Here, we present an update on pathophysiology, diagnosis, and surgical management. When there is clinical suspicion for painful AAOA, providers have numerous diagnostic modalities, including newer hybrid techniques, that can be used to solidify the diagnosis. When conservative efforts fail, C1-2 fusion is an effective and enduring treatment for most patients. Here, we present an update on pathophysiology, diagnosis, and surgical management. To introduce and evaluate the efficacy of the trans-superior articular process (trans-SAP) approac
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