Microsurgical anterior approach to cervical discs. Review of 60 consecutive cases of discectomy without fusion

Abstract

During the past six years 60 patients have undergone anterior cervical microsurgical discectomy without exogenous intercorporal grafting using the operating microscope. This alternative method of treatment is a further refinement of previous techniques for the removal of cervical disc protrusions, which fulfils all the criteria of effective surgery. Discectomy provides ample exposure of the neural elements through the disc space. The visualisation of the underlying pathology is adequate through direct light and magnification of the operating microscope. A radical surgery is possible without danger of injury to the nervous structures or to the vertebral artery. The functional stability of the adjacent vertebral segment is, present immediately after discectomy. A spontaneous fusion occurs in 70% of cases in six months to one year. Risks and complications of the procedure are few. Long term results are excellent, with overall benefit from surgery in 95% of cases. Comparing the results of anterior microdiscectomy without bone grafting with those of other procedures, there are no significant differences.