Anterior cervical discectomy: an analysis on clinical long-term results in 153 cases

During the last three decades, the anterior approach to the cervical spine with interbody fusion has been increasingly preferred in the operative treatment of herniated cervical disc. Most studies on surgical procedure without interbody fusion are retrospective and reported that the bone graft is not important for the success of this technique. Between 1983 and 1993, 153 patients underwent surgery for the treatment of cervical degenerative disc disease: in 139 cases the technique without fusion was applied. This retrospective study analyze clinical and radiological parameters in order to verify any possible prognostic factor. 108 patients with radiculopathy and 31 patients with myelopathy were followed up clinically for at least 12 months up to 10 years. An excellent or good long-term result was achieved in 90.9% of patients with radiculopathy and 58.1% of those with myelopathy. The age of the patients, the duration of symptoms before diagnosis and the pathogenesis of disc herniation did not represent significant parameters influencing the outcome of patients. The results of the present study show that anterior discectomy without fusion lead to good clinical long-term results, either in patients with pure radicular syndrome, or in cases with myelopathy. The presentation with pure radicular signs is the most important factor in predicting a good overall outcome.