On the basis of increasing experience, only by keeping strictly to the basic rules, especially through the advantages of a stable internal fixation, better results can be obtained with surgical treatment of cervical spine injuries. For surgical treatment related to the given anatomical situation, the injuries must be subdivided into those above C 3 and the injuries at or below C 3. In injuries above C 3, we would regard the axis body fracture with or without a hangman's fracture and a fresh fracture-dislocation or pseudoarthrosis of the odontoid process as requiring an operation. In injuries above C 3, a posterior modified stabilization without cranial fixation is recommended. The injuries at and below C 3 generally require an anterior approach. With axial deviation, dislocation and fracture-dislocation a stable internal fixation is performed in addition to the fusion of the intervertebral space. With compression and severe compression fractures, the vertebral body is pulled back and firmly fixed by two wires drawn through epidurally behind the vertebral body. The indications for and the late results of early surgical treatment are presented in 125 cases who have undergone such treatment.