Posterior intra-articular distraction with cage placement to treat congenital atlantoaxial dislocation associated with basilar invagination Wanru Duan, MD,1 Dean Chou, MD,2 Fengzeng Jian, MD, PhD,1 and Zan Chen, MD, PhD1 1Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China; and 2Department of Neurological Surgery, University of California, San Francisco, California Congenital atlantoaxial dislocation (AAD) associated with basilar invagination (BI) is a complex congenital malalignment at the craniovertebral junction. The olisthesis, atlantoaxial facet joint arthropathy, and the contraction of the anterior soft tissue make the treatment challenging. Our video demonstrates the surgical technique for posterior intra-articular distraction with cage placement to treat congenital atlantoaxial dislocation associated with basilar invagination. 10.3171/2020.3.FocusVid.191001