The outcome of treatment of cervical disc disease is becoming progressively much better after the development of new techniques in neurodiagnosis and surgical procedures. This work is done to present our experience in management of 60 patients with single-level cervical disc disease. These patients were operated upon using anterior cervical discectomy with bone graft in theperoid between 1997 and 2001. Age of the patients ranged between 32 years and 69 years with an average age of 44 years. Thirty-eight patients (63.3%) had radiculopathy and 22 patients (36.7%) had myelopathy. The herniated disc was the main offending compressing pathology as proved by MRI. The commonest levels affected were CS_6 and C4_S' Excision of the posterior longitudinal ligament (PLL) was done in 11 patients (18.3%) with the help of operating microscope to remove the subligmentous herniated disc material.
The final outcome using odom' s[ 8] criteria was excellent to good in 54 patients (90%) and none of our patients showed cervical instability during the postoperative follow-up period. Radiculopathy had responded well and early to surgery, while in myelopathic patients, improvement was achieved in motor power to variable extent in a much slower rate but poor outcome was noted in elderly patients who had poor preoperative clinical status and severe cord compression with abnormal cord signal. Transient dysphagia and hoarseness of voice were the commonest postoperative complications.No mortality or irreversible morbidity related to surgery were reported in this study. Our results suggest that anterior cervical discectomy with bone graft is a recommended procedure for the surgical treatment of single-level cervical disc disease not only because of its efficacy and safety with minimal complications but also it could achieve a high rate of success in relieving smptoms and bone fusion. |
