Anterior microsurgical approach for degenerative cervical disc disease

One hundred-ninety-six patients with spinal cord or nerve root compression were operated on by anterior microsurgical discectomy without graft between 1978 and 1987. The patients presented either with spinal cord compression (33%) or radicular symptoms with a duration of 12 days to more than then years (66%). Investigations to confirm these clinical syndromes employed myelography, CT or MRI. Two-hundred-eighty-eight levels were explored; 124 one level, 54 two level, 17 three level and 2 four level operations were done. The follow-up (mean 6.7 years) showed 66% of the patients with excellent or good results after two years. The low risks of anterior discectomy were further diminished with skillful microsurgical technique without intercorporeal fusion. A comparison of our results at follow-up with published series, in which the anterior approach was used but with intervertebral autologous bone graft after disc removal, shows no significant differences. We therefore recommend the anterior microsurgical discectomy without fusion as the treatment of choice.