IS PATHOLOGY EXAMINATION OF DISC SPECIMENS NECESSARY AFTER ROUTINE ANTERIOR CERVICAL DISKECTOMY AND FUSION

Study Design. A retrospective chart review was performed form 1990-199 4. Objectives. To evaluate the outcome of pathologic examination of ce rvical disc specimens submitted after anterior cervical discectomy. Su mmary of Background Data. This study is the first to review the outcom e of pathologic examination of disc specimens after anterior cervical discectomy and fusion. Methods. Charts were reviewed based on the proc edure code of anterior cervical fusion and the main diagnosis of cervi cal disc and spondylosis. The following data were recorded for each pa tient: symptoms, examination, diagnostic studies, operative procedure, operative findings, and pathology report. Statistical analysis was pe rformed. Results. Five hundred six disc levels in 394 patients were re viewed. All patients had symptoms and examination results consistent w ith cervical radiculopathy. All patients had cervical radiographs and some combination of myelography, computed tomography, or magnetic reso nance imaging. Findings at the time of surgery included the presence o f either a herniated disc or degenerative spondylitic changes. The pat hologic examination results of all specimens reported fibrocartilagino us tissue consistent with disc material with the presence of degenerat ive changes. No infectious, benign, or malignant process was identifie d at the time of surgery or on gross and histologic examination of any of the disc specimens. Using confidence intervals (95%) for exact pro portions and given 500 negatives, the chance or next occurrence would be positive would be 0.0060 or 0.60% or six of 1000. Conclusions. This study shows that if the symptoms, physical examination, radiographic diagnostic studies, and surgical findings are consistent with those of cervical disc herniation or spondylosis, the chance of an unexpected, clinically important pathologic finding within the disc specimen is e xtremely small. The time and expense involved in routine pathologic ex amination of cervical disc specimens can be avoided.