Anterior surgery for the treatment of soft cervical disc herniation

The authors present the results obtained in a series of 57 cases of soft cervical disc herniation submitted to anterior surgery. The cases included 52 radiculopathies and 5 myeloradiculopathies. Among the radiculopathies, 20 cases were treated by discectomy without magnification, and interbody fusion, and 32 by radical microdiscectomy, completed with interbody fusion in 19 cases and without fusion in 13. The 5 cases of myeloradiculopathy were all treated by microdiscectomy, with fusion in 2 cases and without fusion in 3. The results of treatment of the radiculopathies were evaluated as excellent or good in 80% of the cases treated by "macro" technique, and in 84% of those treated with "micro" technique; in the latter cases, more rapid and complete regression of pain, were always observed probably due to the more radical neurological compression obtained. The 5 cases of myeloradiculopathy obtained excellent results, with evident sensory and motor recovery. Long-term results for cases treated with or without fusion did not differ; the complications observed in the entire series may all be related to use of interbody grafting. The authors conclude that the method of choice in the surgical treatment of soft cervical herniation, with radicular or myeloradicular compression, is radical anterior microdiscectomy without interbody fusion.