Selection of surgical modality and efficacy analysis of different types of occipital and cervical deformities OBJECTIVE: To investigate the selection of surgical modality and clinical efficacy of different types of occipital and cervical deformities. Methods: 126 patients with occipital-cervical deformity treated in our hospital from March 2005 to August 2012 were collected and analyzed for the effect of surgical treatment and improvement of spinal cord function. 58 males and 68 females, aged 13-67 years, average 37.4±9.2 years. There were 74 cases of occipital-cervical deformity combined with reversible atlantoaxial subluxation, 24 cases combined with irreversible atlantoaxial subluxation, 20 cases combined with atlantoaxial subluxation, and 8 cases of odontoid deformity and free odontoid process. According to the specific conditions of each patient, posterior atlantoaxial fusion and internal fixation with bone graft fusion (49), posterior occipitocervical fusion and internal fixation with bone graft fusion (53) and posterior occipitocervical fixation with transoral atlantoaxial joint release and repositioning (24 cases) were performed. Postoperative follow-up was performed regularly to compare and analyze the changes in JOA score, bone graft fusion, cervical spine function loss and complications before and after surgery. RESULTS: Bony healing was obtained in all patients, and the postoperative JOA score improved compared with the preoperative one (p<0.05), with an overall improvement rate of 83%. The postoperative loss of cervical rotation function in the three groups was 62.02%±6.84%, 82.025%±4.85%, and 66.75%±13.64%, respectively. One patient had gradual resorption of the implanted autogenous bone after surgery and obtained bony healing after reoperation. Conclusion: According to the type of occipitocervical deformity and the ease of repositioning after preoperative cranial traction, a suitable procedure can be selected to achieve the desired results. Keywords: occipitocervical deformity; atlantoaxial dislocation; odontoid deformity; free odontoid process Occipitocervical deformity is a common clinical condition that can lead to instability of the upper cervical spine and accelerate the degenerative process of the lower cervical spine, often combined with cervical and medulla oblongata compression, and put it in a dangerous state, where minor damage such as falls and impacts can cause increased neurological symptoms or even endanger the life of the patient. Surgery is often needed to restore the normal anatomical relationship of the upper cervical spine, rebuild its stability, and relieve the cervical medulla compression, but because the occipital cervical part is adjacent to important structures such as the medulla oblongata and cerebellum, the anatomical structure is complex, resulting in the difficulty and high risk of surgery in this area, which can cause serious consequences if the surgical method is not chosen properly. The selection of surgical methods for various types of occipital and cervical deformities has been given great attention at home and abroad. Many new and effective surgical methods have also been proposed. In this paper, we review and analyze the clinical data of 126 patients with occipital neck deformity admitted to our hospital from March 2005 to August 2012, and summarize the choice of surgical methods for different types of occipital neck deformity to provide help and reference for clinicians in the selection of surgical methods for the treatment of occipital neck deformity.