We report our experience with the CCD material (Sofamor-Danek) for the treatment of cranio-cervical instability. In this method, rod-plates are fixed to the occipital bone and to the cervical spine with hooks. This technique is mainly indicated for the treatment of patients with severe osteoporosis or with significant thinness of the occipital bone. Four cases are presented. Three of them suffered from a inflammatory rheumatism. The fourth patient had been previously treated by an occipito-cervical fixation with a Roy-Camille plate for a C2 metastasis and presented a failure of the occipital screws fixation. In all cases, no post operative complications were observed and all patients had a significant improvement of their cervicalgia. We confirm the interest and the fiability of the CCD method which has simplified the procedure and is specially suitable for the treatment of all types of cranio-cervical instability, even in the most adverse conditions.