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Tegner activity scales. Further, concurrent ACLR did not significantly affect these outcomes. IV, systematic review of level I-IV studies. IV, systematic review of level I-IV studies. Odontoid fracture is a common injury in the upper cervical spine that can sometimes be managed by anterior odontoid screw fixation. We report the first case of iatrogenic postero-inferior cerebellar artery (PICA) injury while performing anterior odontoid screw fixation for a type II odontoid fracture in a 22-year-old man. Fisher grade 4 subarachnoid hemorr