OBJECT: Cervical spine injury is a commonly encountered entity in most neurosurgical practice and is increasing with social environment. Universally accepted treatment modality for acute cervical spine injuries do not exist and several areas of controversy surround the issue of surgical intervention in the management of trauma to the cervical spine. METHODS: A retrospective study of 86 injured cervical spine patients who admitted and carried out a surgical treatment at Dong Dae Moon Hospital between Sep.92 and Aug.96 for the past four-year-period. RESULTS: The author analyzed 86 patients with traumatic cervical spine injuries for the past 4 years. The incidence was highest in middle aged men(ratio : 6.8) and the traffic accident was the most common exclusive cause(68%). In 9 cases of C1-2 spine injury, they underwent posterior approach. In 74 cases of mid-lower(C3-7) cervical injury, the anterior approach was used in 57 patients, the posterior approach was used in 13 patients and the combined approach was used in 4 patients. The surgical complication rate was 15%(13 cases). CONCLUSION: Internal fixation with variety of devices has become a popular procedure for cervical spine injuries. In this study, the rate of re-operation and complications following initial surgical procedures were found to be higher than previous report of other authors. It could be concluded that choosing the most proper surgical approach for cervical spine injuries with minimal risks and adhering to stringent criteria are much important than simply selecting new fancy devices over the traditional one.