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Objective:To study surgical strategy of the posterior approach for atlantoaxial instability.Methods:Seventy-eight patients with atlantoaxial instability were treated by different surgical approach.Of the 78 cases,there were 35 cases of type Ⅱ òⅢócombined Jeffersonfractures.5 cases of congenital defects of occipitocervical instability.28 cases were treated by combined use of Magefl and Apofix system,9cases by Apofix system,15 cases by Cland C2 pedical screw system,26 cases by Posterior occipitocervical reconstruction.