Abstract： Objective To observe the therapeutic effect of different surgical treatments on cervical hyperflexion injury with anterior spinal cord syndrome.Methods Clinical records of 39 cases of cervical hyperflexion injury with anterior spinal cord syndrome in the Second Hospital of Tangshan were collected from January 2015 to April 2017.The patients were treated with different surgical methods according to individual conditions.Japanese Orthopedics Association (JOA) score was observed before and 1 year after operation to evaluate the surgical effect.Results Patients with simple anterior dislocation after cranial traction reduction and patients with intervertebral disc injury without fracture dislocation were treated with anterior cervical surgery to remove the injured disc;autogenous iliac bone or interbody fusion apparatus was used for internal fixation.Patients with vertebral fracture were treated with cranial traction and anterior subtotal vertebral body resection;autogenous iliac bone or titanium mesh was used for internal fixation.For patients with facet joint fracture,vertebral plate fracture or facet incarceration that can not be treated with traction reduction,combined posterior open reduction and laminectomy decompression,lateral plate or pedicle screw internal fixation were optional operation choice.Patients with hypertrophy of ligamentum flavum,ossification of posterior longitudinal ligament or developmental spinal stenosis should have combined anterior and posterior approach surgery.All fractures and dislocations recovered well after surgery;no serious complications such as infection and internal fixation failure was observed during follow-up.In 39 patients,the total score of JOA at 1-year after surgery was significantly higher than that before surgery[(6.02 ± 1.45) vs (2.74 ±0.58)] (P ＜0.05).Conclusion Surgical strategy of cervical hyperflexion injury with anterior spinal cord syndrome should be chosen according to the injury type,imaging features and clinical manifestations;patients will have good prognosis after optional surgery.