Abstract:[Objective]To discuss the surgical outcomes of C2-3 ACDF for treatment of Type Ⅱ and Type Ⅱa Hangman’s Fractures. [Methods] A prospective clinical design was adopted in this study. Twenty-three cases with Type Ⅱ and Type Ⅱa Hangman’s Fractures admitted to our hospital during Jun 2012 to Jun 2018 were followed up. According to Levine and Edwards’ classification system, 17 cases were typeⅡ and 6 cases were type Ⅱa. C2-3 anterior cervical discectomy and fusion (ACDF) was performed to manage the Hangman’s fracture. VAS neck pain scores, NDI scores, ASIA grades, complications, C2-3 angulation, C2-3 translation, fusion rates and patient satisfactions were employed to evaluate surgical outcomes. [Results] The average follow-up period was 9.87±5.00 months (range 6–24 months). VAS neck pain scores and NDI scores at 1 week after operation were lower than that of pre-operation (p<0.01), VAS neck pain scores and NDI scores at 6months after operation were lower than that of 1 week after operation and pre-operation(p<0.01). Two cases with ASIA grade D pre-operation were still ASIA grade D at 6 months after operation and were ASIA grade E at 1 week after operation. C2-3 angulation at 1 week (2.44±1.50)° after operation were lower than that of pre-operation (11.26±4.00)° (p<0.01), C2-3 dislocation at 1 week (0.96±0.82mm) after operation were lower than that of pre-operation (4.21±1.47mm)(p<0.01). No statistical difference of C2-3 angulation and C2-3 dislocation was observed at 6months after operation than that of 1 week after operation (p>0.05). 86.96% patients felt very satisfied, 13.04% patients felt satisfied and no patients felt not satisfied with the surgical outcomes. 22 cases obtained a 95.6% fusion rate at 6 months after operation, the only non-fusioned case obtained a final bony fusion at 9months after operation. [Conclusion] The surgical outcomes of C2-3 ACDF for treatment of Type Ⅱ and Type Ⅱa Hangman’s Fractures are promising. C2-3 ACDF should be the first choice for the treatment of type Ⅱ and type Ⅱa Hangman fracture without contraindications of ACDF.