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Posterior internal fixation associated with bone fusion is indicated in those traumatic cervical spines in which an additional posterior direct action is required to achieve reduction and/or decompression. The internal fixation device is represented by screw plates allowing strong anchorage, short fixation, and light postoperative immobilization. Twenty-three cases of posterior internal fixation in traumatic cervical spines are presented. In selected cases, the results can be estimated as very good with respect to instability, spinal balance involvement, canal stenosis, and reversible neurologic involvement.