Dentate fractures have a high non-healing rate and a tendency to atlantoaxial instability, which may lead to acute or chronic injury to the brainstem, spinal cord or nerve roots once displaced, causing tetraplegia, respiratory impairment or even death. Non-surgical treatment (cephalothoracic cast, traction and Halo brace, etc.) is relatively safe, but requires long-term bed rest, frequent complications, long healing time, high non-healing rate, and posterior occipito-cervical fusion or atlanto-axial fusion at a later stage, which is very traumatic and results in serious loss of cervical motion function. The greatest advantage of internal fixation with a dentate screw is that it preserves the rotational function of the upper cervical spine, conforms to the biomechanical characteristics of the cervical spine, provides immediate fracture stability, has a high healing rate, and avoids the disadvantages of atlanto-axial fusion or occipitocervical fusion and non-surgical treatment. The anatomy of the upper cervical and craniocervical segments is complex, with the medulla oblongata behind the dentate process and the trachea, esophagus, vagus nerve, large cervical vessels and their branches in front. The dentate process is at most 9 mm wide and 3 cm long, and the position of the screws must be located in the median axis after repositioning of the dentate fracture, requiring a very delicate and accurate operation, which does not allow the slightest deviation, let alone repeated operations. The entire procedure must be performed under simultaneous X-ray surveillance to instantly and clearly locate the direction, depth, and position of the guide pin and screws at the fracture end in order to prevent damage to vital structures. If the technique is not performed properly or used in contraindications, there are more complications and even unpleasant consequences. It requires special instruments and a “C” arm X-ray monitor, which is expensive and difficult to promote in China. The successful completion of this surgery marked a new level of spine surgery technology in our hospital.