A case history of a patient with rheumatoid (Marie-Strumpell) spondylitis, who developed quadriplegia following spontaneous dislocation of the Atlanto-axial joint, is presented. Successful treatment of the high cervical cord compression by means of a laminectomy and fusion of the occiput and the Atlas with the 3d and 4th cervical segments is described. The patient made an uneventful recovery, and regained the use of all of his extremities.