Objective To compare the biomechanical stabilities of fixation with bilateral C1 hooks plus C2 pedicle screws, fixation with C1-C2 transarticular screws plus Gallic wires and fixation with C1-C2 pedicle screws. Methods Six specimens of cervical spines (C0-C4) taken from 6 fresh-frozen human their intact condition, destabilization by disrupting the transverse-Mar-apical ligament, fixation with transar-ticular screws plus Gallic posterior wires, fixation with C1 hooks plus C2 pedicle screws, and fixation with C1-C2 pedicle screws.Pure moment loading, up to 1.5 N·m, was applied to the occiput in flexion-extension, right-left lateral bending, and right-left axial rotation to determine the relative intervertebral rotations using a camera system. The ranges of motion (ROM) for the intact, destabilized and 3 fixation sce-narios were determined. Statistical analyses were performed using one-way analysis of variance, with Fishers least significant difference post hoc test for multiple comparisons. Results The data indicated that the C1-C2 motion significantly increased for all rotations in the cases of disrupted ligament. The motion in all the 3 fixations significantly reduced compared with the intact and destabilized cases (P 0.05). Conclusions The C1 hooks plus C2 pedicle screws fixation appears as effective as the fixations with transartieular screw-wiring construct and C1-C2 pedicle screws in reducing the relative atlantoaxial motion in a severely destabilized upper cervical spine. In cases where the latter two methods are not feasible, fixation with C1 hooks plus C2 pedicle screws may be a safe alternative for treatment of atlantoaxial stabilization. Key words: Atlantoaxial joint; Fracture fixation, internal; Biomechanics