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Objective:To evaluate the safty and feasibility of free-hand implantation technique of pedicle screw without intraoperative image monitorings in lower cervical spine.Methods:Sixty-two patients with cervical spondylosis were treated with Axis system (Ltd Sofamor Am) via cervical posterior approach and pedicle screw fixation.A total of 314 pedicle screws was inserted.The preoperative lateral and oblique radiographs should be observed carefully.The inserting position and the diameter of pedicle were meassured by axial computerized tomography.The lateral mass and facet should be exposed clearly intraoperatively.The cortical bone of lateral upper quadrant of lateral mass was removed by the high speed bur.Then the hole was drilled to the direction of pedictes by a 2mm-diameter hand-awl.This process should be completed naturally without resistance.