We reviewed 13 cases of unstable cervical spine treated by stabilization with posterior Roy-Camille plates and fusion. The patients were treated between 1985-1988. Six patients had acute traumatic episodes, three patients had posttraumatic instabilities, one patient had laminectomy for cervical spondylotic myelopathy, and three patients had metastatic bone disease. All had successful fusion in approximately 3 months without complications. The indications and techniques of posterior Roy-Camille plating are outlined.