Anterior operations in cervicarthrosis and vertebral artery compression

Pain in the cervical spine in the course of degenerative changes is a frequent complaint reported by patients seeking the help of various specialists. Depending on the location of pathologic changes, the pain in the spine may be accompanied by a whole array of signs and symptoms, which are sometimes more troublesome for the patient than the back pain itself. The symptoms are sometimes so persistent and difficult to treat that they lead the patient to apathy and depression, even to the point of suicidal attempts. Should serious aggravation of symptoms develop despite all efforts at successful conservative therapy, surgical treatment is employed to remove the osteophytes protruding into the lumen of the vertebral canal and compressing the spinal roots. An analysis from 1969 to 1988 of treatment in 237 patients with neurologic disorders and concomitant or dominant disturbances of blood flow in vertebral arteries showed that there are specific indications for surgical decompression of the arteries, i.e., when lumen is constricted by the osteophytes at the level of uncovertebral joints. In a series of 47 patients, 42 cases were found to be pain free.