Objective:To investigate the application of modified occipitocervical fusion surgery in upper cervical spine revision surgery. Methods: From June 2002 to January 2006, 11 patients who required reoperation after upper cervical spine surgery due to upper cervical instability, residual cervical spinal cord compression, or tumor recurrence were treated with the self-developed occipitocervical fusion screw combined with cervical pedicle screw occipitocervical fixation system. 9 patients were followed up, and the primary diseases included congenital occipitocervical fusion deformity in 3 cases, upper cervical spine tumor in 2 cases, upper cervical tuberculosis in 2 cases, and cranial vault pitting in 2 cases. There were 2 cases of upper cervical spine tumor, 2 cases of upper cervical spine tuberculosis, and 2 cases of skull base depression. The preoperative and postoperative neurological evaluations were performed using the Frankel grading criteria, and the fusion was evaluated on the basis of the postoperative radiographs at the time of the operation and at the time of the follow-up. Results: There was no intraoperative neurological or vascular injury. At the mean follow-up of 25 months from 7 to 28 months, all 9 patients had achieved osseous fusion without complications such as nail breakage or failure of internal fixation. Conclusion: The occipitocervical fixator composed of occipital plate barrier screws and cervical pedicle screws has a strong fixation effect, and it is a supplement to the conventional occipitocervical fusion surgery. It is suitable for the patients who need to be reopened for the upper cervical segmental lesions due to the instability of upper cervical vertebrae and residual cervical cord compression after the first surgery, especially for the patients with occipital bone defect, thin bone at the base of the skull, and osteoporosis.