[Ventral operations in cervical disk hernia. Neurosurgical experiences in 400 surgical patients]

The indications for simple ventral discectomy as well as for the classical Cloward's operation, together with the surgical techniques employed and the results obtained, are compared in a group of 400 patients treated operatively for cervical disc hernia. The ventral approach is sparing for both the spinal cord and the nerve roots and gives satisfactory results from the point of view of stability. In more than one-half of the patients, luxated fragments of the nucleus pulposus were found epidurally, so that fairly frequent exploration of the epidural space was necessary. Simple microsurgical discectomy (performed in a total of 158 cases) is now more often used than the classical Cloward's operation (242 cases). In 1987 we carried out simple discectomy in 75% of cases. Cloward's operation with extirpation and bone grafting is, however, advantageous in patients with severe spondylosis as well as in cases of traumatic or degenerative instability.