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  Česky / Czech version Čes. a slov. Neurol. Neurochir., 65/98, 2002, No. 6, p. 401–409.
 
Anterior Microdiscectomy and Somatectomy in Degenerative Diseases of Cervical Spine. Experience from the last Decade and Development in the Years 1998–2001 
Häckel M., Stejskal L., Beneš V. ml. 

Neurochirurgická klinika 1. LF UK a IPVZ, ÚVN, Praha
 


Summary:

       The authors present in a retrospective study the results assembled in 301 patients treated by anterior cervical discectomy and somatectomy. The work refers to previous results obtained in a group of 403 patients treated in the same way at the authors’ previous workplace (a total of 704 patients).The authors record short-term and medium-term results (2 months, 1 year) and compare in particular the results in patients with root symptoms without myelopathy and specially in patients with myelopathy. A total of 396 discectomies and 25 corpectomies were performed. Within two months after operation 17 patients recovered completely (5.65 %), 215 improved (71.4 %), the condition remained unchanged in 55 patients (18.3 %) and deteriorated in 14 patients (4.65 %). One year after surgery 50 patients recovered (16.7 %), 190 patients improved (63.1 %), no improvement occurred in 41 patients (13.6 %), in 20 patients the condition deteriorated (6.64 %). Slightly poorer results were recorded in patients with spinal damage than in patients with root symptoms without a spinal lesion. The difference between the two groups was greater during early check-up examinations (by 34.8 % fewer patients with myelopathy recovered or improved 2months after surgery) than during later check-up examinations (12months: the difference between the two groups was 5.6 %). The condition of patients with myelopathy improved after surgery later than in patients with root symptoms. The authors discuss the assembled results and comment the development and importance of stabilization after neurosurgical anterior decompression of the cervical spine. They consider fusion, using a tricortical autologous graft, as the optimal method which in cervical discectomies does not require fixation by a metal implant. Their conclusions are based on long-term (three-year) results of single- and two-stage discectomies and short-term (one year) results of three-stage discectomies. In somatectomies and fusions using a high tricortical autologous graft they recommend fixation by a metal implant (stent).

        Key words: cervical spine,degenerative disease, radiculopathy,myelopathy, anterior approach, surgical treatment
       

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