Cervical discectomies by the anterior approach.

S R Figueiredo, J P Vital, M L Dominguez, J A Campos


A retrospective study was made of sixty patients who underwent anterior cervical surgery, between January, 1980 and May, 1989. The standard anterior approach devised by Cloward (DEC) was used for 28 patients, and discectomy alone (DS), without bone graft, for the other 32. The postoperative stay was 2.4 times longer after DEC than after DS. Surgical complications had an incidence of 11.6%, 14.3% with DEC and 9.3% with DS. There was no mortality. A total of 57 patients were available for transversal clinical evaluation, 26 of the DEC group and 31 of the DS group. There was no difference in the success rate between the two groups. Considering the over-all results, 77.2% had good or excellent results, 10.5% had fair results and 12.3% had poor results. Patients with radicular symptoms alone had better results. Evolution of the spine stability at the level of the intervention was of no major difference between the two groups. The authors conclude that there are identical results, whatever the technique used. Still, morbidity and postoperative hospitalization are higher with Cloward's approach, which seems a good reason to restrict its use to cervical instability situations, namely traumatic cervical pathology.

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