Cervical spinal cord injury is a tragic trauma causing immediate serious quadriplegia and respiratory paralysis. In unstable injuries with paralysis, emergency surgery must be performed immediately to achieve spinal cord decompression and spinal column stabilization. In the treatment of dislocation fractures, first priority should be given to reducing the dislocation, by which the spinal cord is decompressed. A successful attempt to reduce the dislocation using skeletal traction is followed by elective surgery for fixation. In the case of a failure in reducing the dislocation, surgery with a posterior approach is performed to reduce the dislocation and provide internal fixation. In patients with considerably affected anterior column stability and those with any anterior compression that must be eliminated, such as intervertebral disc herniation or a vertebral body fragment, anterior decompression and fixation surgery is indicated.