CASE: A 7-year-old boy with chondrodysplasia punctata (CDP) and cervical myelopathy due to kyphosis with os odontoideum underwent anterior and posterior fusion from C2 to T2 with the aim of avoiding occipital fusion. However, occipital fusion was required 9 months after the initial surgery because of dysphagia caused by atlantoaxial subluxation. CONCLUSION: The surgical strategy for cervical kyphosis with os odontoideum in patients with CDP remains controversial. We attempted to avoid occipital fusion
however, midcervical fusion resulted in instability at the os odontoideum, which necessitated extending the fusion to the occiput.