There are sparse data concerning redo surgery for failed odontoid screw fixation and posttraumatic spinal stenosis C1-2. Also, a comprehensive classification of odontoid and C2-vertebral body fractures does not exist. We report on a referred patient with spinal stenosis C1-2 following anterior screw fixation for an alleged unstable odontoid type III fracture, secondary cutout of the odontoid screw, malunion at the fracture site, and uncommon redo anterior fusion C2-3. Utilizing static and dynamic X-rays, MRI, dynamic CT and MRI, and neurophysiological tests, the indications for revision surgery were worked up. Finally, surgical intervention in our patient was not performed. The patient remained free of symptoms in one-year follow-up. Spinal stenosis C1-2 following an odontoid type III fracture is discussed on a selected review of literature. The strictly applied classification in our case, as well as its definition of osseous instability is scrutinized. Full diagnostic work up and a review of literature supports approaching treatment solutions in failed odontoid surgery with spinal stenosis C1-2, but an individual biomechanically based approach to odontoid and vertebral body fractures of C2, and their failed surgery is still demanded.