Abstract Objective To compare the effectiveness and safety between TINAVI navigated and free-handed pedicle screw insertion through posterior paraspinal approach in treatment with lower cervical fracture and dislocated injury. Methods 32 case files involving treatment with cervical fracture and dislocated injury in a posterior approach were collected from January 2016 to January 2020 in a retrospective research. Paients were devided into two groups according to different surgical procedures. In group A, cervical pedicle screws were placed by conventional free-handed technique, while in group B, screws were inserted with the assisstance of TINAVI navigation system. Perioperative data, follow-up outcome and fluoroscopic files of both groups were analysized. Results Surgical operations in both groups were carried out successfully, without nerve, vascular or esophagus injury. The operation time, blood loss, frequency of explosed to radiation and lengh of hospital stay were significantly less in Robot group(P<0.05). No wound complications occurred in the robot group, while in the conventional group, 3 patients suffered fat liquefaction and were finally cured by anti-infection and wound dressing. The mean time of follow up was 27.35±4.37 months. Time differentce of totally weight bearing in both groups was not statistically signicant(P>0.05). The pre-operative VAS and JOA scores in both group were not significantly different(P＞0.05). While in the following-up duration, JOA socres in both groups were not statistically different(P>0.05). The ASIA degrees improved. Patients in both groups achieved neural function improvement at different levels by the last follow up. Bony fusion occurred in both groups in 16 weeks after operation, with no significant statistic difference(P>0.05). The pre-operative cervical Cobb angle and minimum sagital diameter in both groups were not significantly different(P>0.05), while recovered, with signidicant stastic difference when compared with data of pre-operation. Conclusion Compared with conventional free-handed pedicle screw insertion, TINAVI navigation takes more advantages in less surgical injury and more accuracy in screw insertion, resulting in an effective method in mini-invasive spinal surgery.