A method of rigid occipitocervical fixation is described which uses an occipital pin passed through the external occipital protuberance. Additional rods and wires are used to complete the fixation. The occipital pin was tested in a cadaver skull and was found to be able to withstand a distraction force of 30-50 kgs. Three patients with grossly unstable upper cervical spines due to cancer metastasis were able to walk as a result of this surgery.