Anterior surgery for cervical disc disease

1980 ◽  
Vol 53 (1) ◽  
pp. 1-11 ◽  
Author(s):  
L. Dade Lunsford ◽  
David J. Bissonette ◽  
Peter J. Jannetta ◽  
Peter E. Sheptak ◽  
David S. Zorub
Keyword(s):  
Disc Herniation ◽  
University Hospital ◽  
Cervical Disc ◽  
Complete Relief ◽  
Anterior Fusion ◽  
Disc Disease ◽  
Anterior Surgery ◽  
Cervical Surgery ◽  
Anterior Cervical Surgery ◽  
Results Of Surgery

✓ Between 1971 and 1977, 334 patients at the Presbyterian-University Hospital underwent anterior surgery for treatment of hard or soft cervical disc herniation. Of these patients, 295 had radicular symptoms only. This retrospective study details the results of anterior cervical surgery for treatment of lateral disc herniation in 253 patients who survived 1 to 7 years postoperatively. Sixty-seven percent had excellent or good results. Although 77% initially noted complete relief of symptoms after surgery, 38% subsequently developed one or more recurrent symptoms at some time during the follow-up period. The overall results of surgery for soft disc cases were no different from the results for hard discs, although significantly more hard disc cases required postoperative conservative treatment. The results of surgery after anterior fusion were no different than the results after anterior discectomy alone. However, overall postoperative complications were more frequent and hospitalizations were longer in the patients who underwent fusion. Patients with multiple-level surgery had statistically similar results to those with single-level surgery. None of the nine preoperative clinical features reported by others to influence the results of anterior cervical surgery were found to consistently affect outcome in the present series.

scholarly journals Anterior cervical surgery to treat diffuse idiopathic skeletal hypertrophic combined with cervical disc herniation

Medicine ◽  
2021 ◽  
Vol 100 (22) ◽  
pp. e26097
Author(s):  
Kun Gao ◽  
Yafei Cao ◽  
Weidong Liu ◽  
Shufen Sun ◽  
Yihong Wu ◽  
...  
Keyword(s):  
Disc Herniation ◽  
Cervical Disc Herniation ◽  
Cervical Disc ◽  
Cervical Surgery ◽  
Anterior Cervical Surgery

Astronaut Michael Collins, Apollo 8, and the anterior cervical fusion that changed the history of human spaceflight

2019 ◽  
Vol 31 (1) ◽  
pp. 87-92
Author(s):  
Richard Menger ◽  
Michael Wolf ◽  
Jai Deep Thakur ◽  
Anil Nanda ◽  
Anthony Martino
Keyword(s):  
Air Force ◽  
Disc Herniation ◽  
The United States ◽  
Cervical Disc ◽  
The Moon ◽  
Cascading Effect ◽  
Cervical Surgery ◽  
History Of ◽  
Anterior Cervical Surgery ◽  
The Impact

In 1961, President John F. Kennedy declared that the United States would send a man to the moon and safely bring him home before the end of the decade. Astronaut Michael Collins was one of those men. He flew to the moon on the historic flight of Apollo 11 while Neil Armstrong and Buzz Aldrin walked on its surface. However, this was not supposed to be the case.Astronaut Collins was scheduled to fly on Apollo 8. While training, in 1968, he started developing symptoms of cervical myelopathy. He underwent evaluation at Wilford Hall Air Force Hospital in San Antonio and was noted to have a C5–6 disc herniation and posterior osteophyte on myelography. Air Force Lieutenant General (Dr.) Paul W. Myers performed an anterior cervical discectomy with placement of iliac bone graft. As a result, Astronaut James Lovell took his place on Apollo 8 flying the uncertain and daring first mission to the moon. This had a cascading effect on the rotation of astronauts, placing Michael Collins on the Apollo 11 flight that first landed men on the moon. It also placed Astronaut James Lovell in a rotation that exposed him to be the Commander of the fateful Apollo 13 flight.Here, the authors chronicle the history of Astronaut Collins’ anterior cervical surgery and the impact of his procedure on the rotation of astronaut flight selection, and they review the pivotal historic nature of the Apollo 8 spaceflight. The authors further discuss the ongoing issue of cervical disc herniation among astronauts.

Anterior surgery for cervical disc disease

1980 ◽  
Vol 53 (1) ◽  
pp. 12-19 ◽  
Author(s):  
L. Dade Lunsford ◽  
David J. Bissonette ◽  
David S. Zorub
Keyword(s):  
Surgical Techniques ◽  
Cervical Disc ◽  
Cervical Canal ◽  
Cervical Disc Disease ◽  
Disc Disease ◽  
Duration Of Symptoms ◽  
Content Type ◽  
Cervical Surgery ◽  
Anterior Cervical Surgery

✓ The results of anterior cervical surgery for treatment of cervical spondylotic myelopathy (CSM) are assessed 1 to 7 years postoperatively in 32 patients. At follow-up review, 50% were improved after surgery and 50% were unimproved or had deteriorated in spite of surgery. The results could not be statistically linked to the patients' age, duration of symptoms, severity of myelopathy, cervical canal size, or the performance of single- or multiple-level operations. Various anterior surgical techniques were used, but none proved to have superior results. The results in this series failed to surpass the results obtained by others for conservative treatment alone. In many cases, symptoms of CSM progressed despite the intervention of anterior cervical surgery.

scholarly journals Anterior cervical spine surgical complications: Safety comparison between teacher and student

2021 ◽  
Vol 12 ◽  
pp. 43
Author(s):  
Edvin Zekaj ◽  
Guglielmo Iess ◽  
Domenico Servello
Keyword(s):  
Critical Factor ◽  
Anterior Cervical Discectomy ◽  
Cervical Disc ◽  
Cervical Disc Arthroplasty ◽  
Complication Rates ◽  
Years Of Experience ◽  
Cervical Discectomy ◽  
Phone Calls ◽  
Cervical Surgery ◽  
Anterior Cervical Surgery

Background: Anterior cervical surgery has a widespread use. Despite its popularity, this surgery can lead to serious and life-threatening complications, and warrants the attention of skilled attending spinal surgeons with many years of experience. Methods: We retrospectively evaluated postoperative complications occurring in 110 patients who underwent anterior cervical surgery (anterior cervical discectomy without fusion, anterior cervical discectomy and fusion, and anterior cervical disc arthroplasty) between 2013 and 2020. These operations were performed by an either an attending surgeon with 30 years’ experience versus a novice neurosurgeon (NN) with <5 years of training with the former surgeon. Complications were variously identified utilizing admission/discharge notes, surgical reports, follow-up visits, and phone calls. Complications for the two groups were compared for total and specific complication rates (using the Pearson’s Chi-square and Fisher’s test). Results: The total cumulative complication rate was 15.4% and was not significantly different between the two cohorts. The most frequent postoperative complication was dysphagia. Notably, there were no significant differences in total number of postoperative instances of dysphagia, dysphonia, unintended durotomy, hypoasthenia, and hypoesthesia; the only difference was the longer operative times for NNs. Conclusion: Surgeons’ years of experience proved not to be a critical factor in determining complication rates following anterior cervical surgery.

Use of a polymethylmethacrylate cervical cage in the treatment of single-level cervical disc disease

2005 ◽  
Vol 3 (1) ◽  
pp. 24-28 ◽  
Author(s):  
Jyi-Feng Chen ◽  
Chieh-Tsai Wu ◽  
Sai-Cheung Lee ◽  
Shih-Tseng Lee
Keyword(s):  
Cancellous Bone ◽  
Disc Herniation ◽  
Interbody Fusion ◽  
Cervical Disc Herniation ◽  
Cervical Disc ◽  
Cervical Disc Disease ◽  
Disc Disease ◽  
Content Type ◽  
Single Level ◽  
Fine Print

Object. Polymethylmethacrylate (PMMA) bone cement has been used as a spacer in the treatment of patients with cervical disc disease with good long-term outcomes, but solid bone fusion has not been demonstrated in all cases. To achieve cervical interbody fusion, the authors designed a modified PMMA cervical cage that they filled with spongy bone for the treatment of single-level cervical disc herniation. Methods. Sixty-three patients underwent anterior cervical microdiscectomy and implantation of a PMMA cervical cage filled with autograft cancellous bone and were followed for a minimum of 2 years. The fusion rates were 90.5 and 100% at the 6- and 12-month follow-up examinations, respectively. The mean intervertebral disc height gain was 3.4 ± 1.9 mm when preoperative and 24-month postoperative values were compared. Neck pain, measured using the Huskissan visual analog scale (0 mm, no pain; 100 mm, worst possible pain), decreased from 71 ± 13 mm at preoperative baseline to 28 ± 17 at 6, 23 ± 19 at 12, and 31 ± 19 mm at 24 months. Based on the same scale, radicular pain decreased from 83 ± 15 mm at preoperative baseline to 24 ± 11 at 6, 27 ± 13 at 12, and 22 ± 11 mm at 24 months. The self-rated clinical outcome was excellent in 45 (71.4%) and good in 18 (28.6%) of the 63 patients. Conclusions. The autograft cancellous bone—filled PMMA cage is safe and effective for cervical interbody fusion in the treatment of single-level cervical disc herniation and monoradiculopathy.

scholarly journals Artificial Disc Insertion Following Anterior Cervical Discectomy

2003 ◽  
Vol 30 (3) ◽  
pp. 278-283 ◽  
Author(s):  
Gwynedd E. Pickett ◽  
Neil Duggal
Keyword(s):  
Disc Herniation ◽  
Symptomatic Relief ◽  
Clinical Results ◽  
Anterior Cervical Discectomy ◽  
Cervical Disc ◽  
Complete Relief ◽  
Adjacent Segment ◽  
Cervical Discectomy ◽  
Functional Spinal Unit ◽  
Cervical Disc Prosthesis

Objective and importance:Fusion following anterior cervical discectomy has been implicated in the acceleration of degenerative changes in the adjacent spinal segments. Discectomy followed by implantation of an artificial cervical disc maintains the functionality of the spinal unit, while still providing excellent symptomatic relief. We describe our preliminary experience with implantation of the Bryan Cervical Disc System in two cases of single-level cervical disc herniation.Clinical presentation:Two male patients presented with a left C6 radiculopathy, without evidence of myelopathy. Magnetic resonance imaging revealed a disc herniation at C5-6 in both cases. Pre-operative flexion and extension radiographs demonstrated preserved motion at the involved levels.Intervention/technique:Following a standard anterior cervical decompression, precision drilling of the vertebral endplates was carried out using a drill attached to a bed-mounted, gravitationally-referenced retraction frame. An artificial cervical disc, composed of a polyurethane nucleus with titanium endplates, was fitted between the contoured endplates without fixation to the vertebral bodies. No complications were experienced during the insertion of the prosthesis, or in the postoperative course. Both patients experienced immediate postoperative resolution of their radicular pain and were discharged from hospital the following day. At nine months following surgery, both patients continue to have complete relief of radicular symptoms. Postoperative radiographs at six months following surgery confirm accurate placement of the prosthesis and preserved mobility of the functional spinal unit.Conclusion:Insertion of the Bryan artificial cervical disc prosthesis following anterior cervical discectomy is a relatively straightforward procedure, which appears to be safe and provides good clinical results, without requiring additional surgical time. Long-term follow-up is required to assess its safety, efficacy, and ability to prevent adjacent segment degeneration.

scholarly journals Endoscopic foraminotomy using a microendoscopic discectomy system in cadaveric specimens

1998 ◽  
Vol 4 (2) ◽  
pp. E4 ◽  
Author(s):  
Sung Woo Roh ◽  
Daniel H. Kim ◽  
Alberto C. Cardoso ◽  
Richard G. Fessler
Keyword(s):  
Disc Herniation ◽  
Facet Joint ◽  
Contralateral Side ◽  
Cervical Disc ◽  
Foraminal Stenosis ◽  
Transverse Diameter ◽  
Disc Disease ◽  
Cadaveric Specimen ◽  
Open Procedure ◽  
Microendoscopic Discectomy

Although the anterior approach is more commonly performed for the treatment of cervical disc disease, the posterior approach has distinct advantages in selected cases of foraminal stenosis and posterolateral disc herniation. The authors performed cervical key hole foraminotomies using a microendoscopic discectomy (MED) system in four cadaveric cervical spine specimens to evaluate this minimally invasive surgical approach for cervical disc diseases. The amount of bone decompression achieved by using the MED system was compared with that achieved by using the open foraminotomy procedure in each cadaveric specimen. Three noncontiguous cervical nerve roots were selected between C-3 and C-8 in each specimen and were decompressed using the MED system on one side and using the open foraminotomy procedure on the contralateral side. Postoperative computerized tomography (CT) myelography showed that adequate bone decompression was achieved by using either the MED or open procedure in all specimens. Postoperatively, open dissection was performed to confirm and compare the amount of decompression in both the MED and open procedures. The laminotomy size (vertical and transverse diameter), the length of decompressed nerve root, and the proportion of removed facet joint were measured on every operative level. The average vertical diameter of laminotomy area and the percentage of facet removed were significantly greater in the MED procedure than the open procedure (p < 0.05). The transverse diameter of the laminotomy area and the average decompressed root length were not significantly different between MED and open surgery. The authors conclude that endoscopic cervical foraminotomy using the MED system is a feasible procedure and may be clinically applicable in the treatment of foraminal stenosis and laterally located cervical disc herniation.

scholarly journals Three-level cervical disc herniation

2015 ◽  
Vol 29 (3) ◽  
pp. 309-315
Author(s):  
Andrei St. Iencean ◽  
Ion Poeata
Keyword(s):  
Cervical Spine ◽  
Disc Herniation ◽  
The Elderly ◽  
Cervical Disc Herniation ◽  
Herniated Disc ◽  
Cervical Disc ◽  
Disc Disease ◽  
Degenerative Disc ◽  
Spine Pathology ◽  
Rapid Relief

Abstract Multilevel cervical degenerative disc disease is well known in the cervical spine pathology, with radicular syndromes or cervical myelopathy. One or two level cervical herniated disc is common in adult and multilevel cervical degenerative disc herniation is common in the elderly, with spinal stenosis, and have the same cause: the gradual degeneration of the disc. We report the case of a patient with two level cervical disc herniation (C4 – C5 and C5 – C6) treated by anterior cervical microdiscectomy both levels and fusion at C5 – C6; after five years the patient returned with left C7 radiculopathy and MRI provided the image of a left C6 – C7 disc herniation, he underwent an anterior microsurgical discectomy with rapid relief of symptoms. Three-level cervical herniated disc are rare in adults, and the anterior microdiscectomy with or without fusion solve this pathology.

The effectiveness of anterior cervical decompression and fusion for the relief of dizziness in patients with cervical spondylosis

2018 ◽  
Vol 100-B (1) ◽  
pp. 81-87 ◽  
Author(s):  
B. Peng ◽  
L. Yang ◽  
C. Yang ◽  
X. Pang ◽  
X. Chen ◽  
...  
Keyword(s):  
Cervical Spondylosis ◽  
Japanese Orthopaedic Association ◽  
Cervical Disc ◽  
Conservative Group ◽  
Anterior Cervical Decompression ◽  
Cervical Surgery ◽  
One Year ◽  
Anterior Cervical Surgery ◽  
Cervicogenic Dizziness ◽  
Surgical Group

Aims Cervical spondylosis is often accompanied by dizziness. It has recently been shown that the ingrowth of Ruffini corpuscles into diseased cervical discs may be related to cervicogenic dizziness. In order to evaluate whether cervicogenic dizziness stems from the diseased cervical disc, we performed a prospective cohort study to assess the effectiveness of anterior cervical discectomy and fusion on the relief of dizziness. Patients and Methods Of 145 patients with cervical spondylosis and dizziness, 116 underwent anterior cervical decompression and fusion and 29 underwent conservative treatment. All were followed up for one year. The primary outcomes were measures of the intensity and frequency of dizziness. Secondary outcomes were changes in the modified Japanese Orthopaedic Association (mJOA) score and a visual analogue scale score for neck pain. Results There were significantly lower scores for the intensity and frequency of dizziness in the surgical group compared with the conservative group at different time points during the one-year follow-up period (p = 0.001). There was a significant improvement in mJOA scores in the surgical group. Conclusion This study indicates that anterior cervical surgery can relieve dizziness in patients with cervical spondylosis and that dizziness is an accompanying manifestation of cervical spondylosis. Cite this article: Bone Joint J 2018;100-B:81–7.

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