[Clinical diagnosis and treatment of multiple-level injuries of the cervical spine].
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.
Yu
Ze-sheng
ZS
Department of Orthopaedics, Third Hospital of Peking University, Beijing 100083, China.
Liu
Zhong-jun
ZJ
Dang
Geng-ting
GT
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*