Severe sprains of the cervical spine result from a traumatic rupture of the intervertebral disc and ligaments. Although rare, these lesions may lead to a significant kyphotic deformity if they are not surgically treated. The treatment of such a kyphotic deformity may consist of surgical fixation of the lesion through either an anterior or posterior approach. A retrospective study has been done examining 44 severe cervical sprains in 41 patients surgically treated through a posterior approach, using Roy-Camille plates. With an average followup of 29 months (range, 6-60 months), 73% of the patients recovered a normal range of spinal motion, with either moderate or no pain. No neurologic or vascular complications directly attributable to posterior plating and no secondary kyphosis were observed. A moderate sagittal displacement with kyphotic angulation occurred above the fusion in five patients. Posterior screw plate fixation appears to be a safe and effective treatment for severe hyperflexion sprain of the lower cervical spine in the adult.