An implant for positioning between the C1 and C2 vertebral members. The implants may include a blade sized to be inserted between the C1 and C2 members. The blade may include a length measured between an insertion tip and a second side, and a height measured between a superior side that contacts against the C1 vertebral member and an inferior side that contacts against the C2 vertebral member. A leg may be positioned at the second side of the blade. The leg may extend outward below the inferior side of the blade and away from second side of the blade to extend across an exterior of the C2 vertebral member. An aperture is positioned to extend through the implant. The implant may extend through the blade or may extend through a flange that extends from the blade.