The treatment of fixed cervical deformity is complex, but the principles guiding its correction remain the same as in deformity of other spinal regions, with the goal of deformity correction that results in a solid fusion with adequate decompression of the neural elements. In these challenging cases, osteotomies are necessary to mobilize the rigid spine and to obtain the desired correction, but they can be associated with increased risk of complications. Therefore, careful preoperative planning and a complete understanding of the anatomic variations allow patient-tailored approaches with and case specific techniques for the optimal and safe treatment of a variety of complex cervical deformities. We present a case report with a complex spinal deformity where a 3D model was used for surgical strategy that allowed us to "simulate" the osteotomies and get a better correction of the cervical deformity.