Surgical methods for treating diseases of the cervical disc

Abstract

The emphasis of this report is the surgical technique for a disease of the cervical disc. In addition to the Smith-Robinson method, there are many other operative methods that can be considered, such as the Cloward method, a corpectomy or without a bone graft using an anterior approach, and a laminectomy or an expansive laminoplasty for posterior decompression. However, it appears that it is generally agreed that an anterior approach is more effective than posterior decompression. At our institute, our first choice is usually the Smith-Robinson method under microscopy. When using this method, great attention should be taken, not only to avoid a cord injury but also to prevent postoperative hoarseness due to an injury that may occur to the recurrent laryngeal nerve and/or a sensory disturbance of the thigh due to a lateral femoral cutaneous nerve injury. Therefore, the surgeon performing this operation must be well acquainted with the anatomical structure concerned. As for cases manifesting multilevel regions and a severely narrowed spinal canal, posterior decompression is the method selected, and we have recently been using an expansive laminoplasty as the surgical approach. This is because an expansive laminoplasty, unlike a laminectomy, has additional merits, such as postoperative stabilization of the cervical spine and protection against an over-tethering injury of the nerve roots.