Surgical management of cervical radiculopathy. Indication, techniques, and results

Cervical radiculopathy can be surgically approached either posteriorly or anteriorly and the anterior approach has been described with or without fusion. The choice of approach and technique must be based upon anatomic, pathophysiologic, and biomechanical principles in addition to the familiarity of the surgeon with the procedures. The authors discuss the use of the posterior approach for lateral soft-disk disease because it minimizes disruption of soft and bony tissues and does not markedly disrupt the biomechanics of the cervical spine. The anterior approach is preferred for radiculopathy involving osteophytic hard-disk disease, and when properly and carefully performed, the addition of an interbody fusion holds significant advantages over diskectomy without fusion.