Anterior cervical discectomy is a surgical procedure performed to treat a degenerative disease causing radiculopathy and/or myelopathy. The compression of the cord and nerves commonly occurs ventral to the spinal cord.
Venterolateral approach is the better approach for a direct decompression. The most affect levels are C5-C6, C6-C7 and C4-C5 intervertebral spaces. The indications for surgery include:
progressive neurological deficit
static neurological deficit with radicular pain
persistent or recurrent arm pain non responsive to conservative therapy
MRI and CT studies of the cervical spine are performed in order to plane the surgical intervention. CT has more sensivity for osteophyte identification. Cervical radiographs in flexion and extension views are indicated to evaluate the presence of instability.
The goal of the procedure is to decompress the spinal cord and/or nerve roots, mantain or restore stability of the spine, and correct or prevent kyphotic deformity.
The anterior cervical discectomy with intervertebral fusion provide an excellent pain rilief immediately postoperatively. Actually there are several studies investigating the clinical results after the intervention.
After a 2 year follow-up period the clinical results are still good, the rate of fusion is between 93 and 100% and segmental kyphotic deformity doesn’t occur.
Venterolateral approach is the better approach for a direct decompression. The most affect levels are C5-C6, C6-C7 and C4-C5 intervertebral spaces. The indications for surgery include:
MRI and CT studies of the cervical spine are performed in order to plane the surgical intervention. CT has more sensivity for osteophyte identification. Cervical radiographs in flexion and extension views are indicated to evaluate the presence of instability.
The goal of the procedure is to decompress the spinal cord and/or nerve roots, mantain or restore stability of the spine, and correct or prevent kyphotic deformity.
The anterior cervical discectomy with intervertebral fusion provide an excellent pain rilief immediately postoperatively. Actually there are several studies investigating the clinical results after the intervention.
After a 2 year follow-up period the clinical results are still good, the rate of fusion is between 93 and 100% and segmental kyphotic deformity doesn’t occur.
References
- Sonntag VKH, Han PP, Vishteh AG. Anterior Cervical Discectomy. Neurosurgery 49:909-912, 2001.
- Stewart TJ, Schlenk RP, Benzel EC. Multiple Level Discectomy and Fusion. Neurosurgery 60:143-148, 2007.
- Russel SM, Benjamin V. The Anterior Surgical approach to the Cervical spine for Intervertebral Disc Disease. Neurosurgery 54:1144-1149, 2004.
- Xie J-c, Hurlbert RJ. Discectomy versus Discectomy with Fusion versus Discectomy with Fusion and Instrumentation: A Prospective Randomized Study. Neurosurgery 61:107-117, 2007.
