Anterior-approach cervical diskectomy under the operating microscope

Since Cloward's description of it in 1958, the anterior approach to the cervical spine for excision of degenerated cervical disk causing radiculopathy and myelopathy and for excision of secondary bony spurs has become relatively standard for most spine surgeons. The procedure is easy to perform in trained hands, is a low-risk surgical operation, and has gratifying results provided patients are well selected. Many surgeons use an operating microscope while doing the procedure. The obvious advantages of the microscope are better magnification, enhanced stereoscopic visibility in a small field, better visualization of the anatomic structures, and added safety. The focused lighting is valuable in achieving satisfactory decompression of the nerve root and the spinal cord. The microscope is also a valuable teaching tool at the time of surgery. Our technique for the procedure employing the microscope is described and stereoscopic photographs taken during surgery are presented.