SummaryOccipitocervical stabilization for instability due to a variety of pathologies (congenital, posttraumatic, degenerative, infectious, or neoplastic origin) is a challenging procedure. Techniques have steadily been developed over several decades from simple onlay bone grafting requiring long period of immobilization to rigid internal fixation devices allowing early mobilization of the patient while solid arthrodesis occurs. Recently, several modular rod systems have been introduced allowing optimal adaptation to the patient’s anatomic situation and providing excellent stability. This paper describes the development of techniques for occipitocervical stabilization, its indications, the preoperative work-up, and the actual surgical technique of occipitocervical instrumentation using a modular rod system (CerviFix, Stratec, Oberdorf, Switzerland), which was developed and introduced in 1993 by the senior author (BJ). Our experience in 11 patients is reported.