Chesnut R M, Abitbol J J, Garfin S R
Department of Surgery, UCSD Medical Center.
Orthop Clin North Am. 1992 Jul;23(3):461-74.
Cervical radiculopathy can be surgically approached either posteriorly or anteriorly and the anterior approach has been described with or without fusion. The choice of approach and technique must be based upon anatomic, pathophysiologic, and biomechanical principles in addition to the familiarity of the surgeon with the procedures. The authors discuss the use of the posterior approach for lateral soft-disk disease because it minimizes disruption of soft and bony tissues and does not markedly disrupt the biomechanics of the cervical spine. The anterior approach is preferred for radiculopathy involving osteophytic hard-disk disease, and when properly and carefully performed, the addition of an interbody fusion holds significant advantages over diskectomy without fusion.
神经根型颈椎病可以通过后路或前路进行手术治疗，前路手术有融合或不融合两种方式。手术入路和技术的选择除了要基于解剖学、病理生理学和生物力学原理外，还必须考虑术者对手术操作的熟悉程度。作者讨论了后路手术治疗外侧软性椎间盘疾病的应用，因为这种方法能将软组织和骨组织的破坏降至最低，且不会显著破坏颈椎的生物力学。对于涉及骨赘性硬性椎间盘疾病的神经根型颈椎病，前路手术是首选，并且如果操作得当、仔细，椎体间融合术比单纯椎间盘切除术具有显著优势。
