Cervical myelopathy caused by median disc herniation: analysis of the complications following anterior discectomy with and without Fusion Report of 90 cases.

Between 1980 and 1992 about 400 patients underwent anterior cervical discectomy with or without intersomatic fusion at the Department of Neurosurgery of CTO Hospital (Rome) and Nuovo Pellegrini Hospital (Naples). Among them 90 patients were selected (50 from CTO and 40 from Nuovo Pellegrini Hospital). Clinical evaluation of postoperative results were assessed according to Odom's grading system and postoperative complications were discussed. No difference was observed in patients who underwent anterior cervical discectomy with and without fusion; however, postoperative complications were frequently observed in patients who underwent fusion. In conclusion, we consider the anterior microdiscectomy as the treatment of choice for the removal of soft disc herniations with or without osteophytosis even at two level disc. If cervical myelopathy is expression of one or more disc herniations, maybe calcified and associated with marked osteoarthrosic degenerative phenomena, we favour the evacuation of the herniated disc and the removal of osteophytes with Cloward's or Smith-Robinson's techniques.