All patients were acute, multi-segment cervical spinal cord compression injury secondary to lower cervical fracture. These patients underwent emergency posterior cervical pedicle screw-rod/plate instrumentation combined with unilateral open-door laminoplasty. Well-placed pedicle screws and good cervical canal dilation were achieved in all patients, as assessed by radiography. Patients were followed up for 6-10 months and showed at least one class improvement in spinal impairment. These cases suggest that simple posterior cervical pedicle screw-rod/plate instrumentation combined with extensive unilateral open-door laminoplasty could repair acute, multi-segment cervical spinal cord compression injury secondary to lower cervical fracture if the cervical sequence is well preserved and does not require restoration.