title: [Clinical diagnosis and treatment of multiple-level injuries of the cervical spine].
abstract: OBJECTIVE
  To investigate the character, diagnosis and treatment of multiple-level fractures of the cervical spine.
  
  
  METHODS
  Forty-three patients (38 male, 5 female) with multiple-level fractures of the cervical spine were retrospectively analysed in our hospital from 1988-2001.
  
  
  RESULTS
  Among 36 patients with multiple contiguous fractures of the cervical spine, 32 cases were injured at low cervical spine; 7 patients were non-contiguous spinal fractures in which there were 5 cases injured at upper and lower cervical spine. The frequently injured sites were vertebral body (31 patients), laminae (25 patients), spinous process (9 patients), vertebral arch (4 patients), transverse process (5 patients), lateral mass (5 patients); level frequently affected were C(4), C(5), C(6) and C(7); 21 patients were treated with anterior vertebrectomy and fusion, 10 patients with posterior laminectomy and fixation, 2 patients with both anterior and posterior decompression and fixation. 60.5% were flexion-compression injury. 10 patients with conservative treatment.
  
  
  CONCLUSIONS
  Contiguous type was more common than non-contiguous type in multiple level cervical spinal fractures; Injured sites always located at lower cervical spine in contiguous cervical fractures different from that fractures of atlas, axis and lower cervical spine in non-contiguous type; Unstable segments and level of spinal cord injury were at lower cervical spine; Operations must obtain both decompression and stability of spine.
authors.affiliation: Department of Orthopaedics, Third Hospital of Peking University, Beijing 100083, China.
authors.forename: Ze-sheng
authors.initials: ZS
authors.lastname: Yu
authors.forename: Zhong-jun
authors.initials: ZJ
authors.lastname: Liu
authors.forename: Geng-ting
authors.initials: GT
authors.lastname: Dang
mesh_terms: D000293:Adolescent; D000328:Adult; D002574:Cervical Vertebrae / Q000293:injuries* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007796:Laminectomy; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies; D013123:Spinal Fusion; D013124:Spinal Injuries / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy*