Abstract:Atlantoaxial dislocation (AAD) has been internationally regarded as the "surgical exclusion zone", with a very high mortali- ty. With the progress of modern surgical basic research and diagnosis and treatment technology, its clinical outcome is getting better and better. However, various anatomical variations and malformations of the skull base and upper cervical vertebrae, such as basilar invagina- tion combined with AAD, congenital atlantoaxial pedicle stenosis and high abnormal vertebral artery, increase the difficulty and risk of sur- gery. Another example is the clinical problem of medulla oblongata and upper cervical spinal cord injury caused by severe AAD compres- sion, which is still a challenge to modern medical treatment. To solve this clinical problem, individualized application of multiple stability reconstruction techniques is an effective solution. Multiple injuries and medical diseases are the main problems in the perioperative man- agement of atlantoaxial dislocation, while multidisciplinary team model is also an effective way to solve this problem. The academic view- point of "treating spinal diseases from the perspective of governor" and the treatment principle of "dredging the governor arteries by decom- pression of the spinal cord" also provide new ideas for exploring and solving the clinical difficulties of neurological function rehabilitation in spinal cord injury.