Abstract:[Objective] To investigate the clinical outcomes of posterior unilateral door- open decompression combined with pedicle screw fixation for multilevel discoligamentous complex injuries secondary to cervical hyperextension injury. [Methods] From January 2016 to June 2021, 36 patients underwent abovementioned surgical procedures for multilevel discoligamentous complex injuries secondary to cer- vical hyperextension injury. The clinical and imaging data were evaluated. [Results] All the 36 patients had operation performed successful- ly without serious complications. With time of the follow-up period lasted for more than 8 months (before surgery, 3 months after surgery and at the latest follow-up), the ASIA neurological function scale [A/B/C/D/E, (4/10/16/6/0), (0/4/6/12/14), (0/0/4/8/24), P<0.001], JOA cer- vical score [(7.8±2.4), (11.6±2.2), (14.2±1.4), P<0.001] and neck-pain VAS score [(5.2±1.6), (2.9±1.4), (1.6±1.1), P<0.001] significantly improved. However, the cervical curvature measured by imaging showed a decreasing trend over time, but the difference was not statistical- ly significant (P>0.05). Until the last follow- up, all patients had no adverse imaging manifestations such as loosening or fracture of the screws and rods. [Conclusion] The posterior decompression and fixation for multilevel discoligamentous complex injuries leaded by cervi- cal hyperextension have the advantages of sufficient decompression, good recovery of nerve function and strong spinal stability remained, avoiding the complications of long-segment anterior cervical surgery.