Clinical diagnosis and treatment of multiple-level injuries of the cervical spine / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the character, diagnosis and treatment of multiple-level fractures of the cervical spine.</p><p><b>METHODS</b>Forty-three patients (38 male, 5 female) with multiple-level fractures of the cervical spine were retrospectively analysed in our hospital from 1988-2001.</p><p><b>RESULTS</b>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.</p><p><b>CONCLUSIONS</b>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.</p>