EXTENDED ANTERIOR CERVICAL DISKECTOMY WITHOUT FUSION - A SIMPLE AND SUFFICIENT OPERATION FOR MOST CASES OF CERVICAL DEGENERATIVE DISEASE

Of 291 operations performed for cervical degenerative disease causing cord or root involvement over a 12-year period 187 have been treated b y extended anterior discectomy without fusion, removing bone on either side of the posterior disc space so as to give a wide exposure of the anterior spinal and root dura. The technique has been used for 73% of the cases operated on in the last four years. Nine patients (4.8%) re quired an additional posterior decompression for coexisting spinal or root canal stenosis. By the first postoperative follow-up at 2-4 month s 94.5% of patients showed clear neurological or functional improvemen t, 3% were worse and 1.5% had died (the deaths were in elderly patient s with severe myelopathy and intercurrent disease). Minor treatable co mplications occurred in 3.2%. Only two patients (1%) complained of per sistent postoperative neck pain. Patients were mobilized immediately a fter surgery without a collar and most left hospital within 1-4 days. A single level decompression was sufficient in 92% of patients and onl y one patient required more than two levels to be decompressed. In 79% of cases soft disc protrusions contributed to the compression while i n 21% osteophytes alone caused the compression. We believe that this s imple technique is a sufficient surgical treatment for the majority of cases of cervical degenerative disease. It does not require a fusion and avoids the specific problems and complications associated with Clo ward type operations. We are engaged at present in a long-term follow up study of these patients, but to date no late problems have become a pparent.