Anterior Disc Excision with Interbody Fusion in Cervical Spondylotic Myelopathy and Rhizopathy

URGICAL removal of ruptured cervical discs that protrude posterolaterally has usually been handled by partial laminectomy and foraminotomy, which provide a satisfactory nerve root decompression2 ,1~ In central cervical disc protrusion, the posterior approach may result in damage to the spinal cord during the manipulation necessary for removal of the protruded disc. The results of this type of decompression in cases of cervical spondylosis with severe neurological deficit have been very unfavorable, with a high incidence of postoperative morbidity. Since the disc protrusion or the bony ridge is located anteriorly in the spinal canal, the anterior approach developed by Smith and Robinson 2~ and by Cloward 6 seems more mechanically and anatomically sound;not only is the intervertebral disc removed, but bony stabilization is also achieved. However, the results published during the last few years are very contradictory and vary from 100% improvement 11 to 65%. r This variance has prompted us to review our series of 59 patients with cervical spondylosis admitted to the Neurosurgical Department of Karolinska Hospital during the last 7 years and operated on by the technique developed by Cloward?