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Objective To evaluate the effect of Surgical and non-surgical treatment for irreducible atlantoaxial dislocation (IAAD).Methods Patients were abstracted on inclusive criteria and treated surgically or non-surgically.Surgical treatment was performed as open reduction and internal fixation (ORIF) via video-assisted anterior transcervial approach.Non-surgical treatment was that external fixation combined with Physiotherapy.Clinical characteristics,neurological and imageological benefit were compared in surgery and non-surgery group after 8-24 follow up.