Clinical Study of 79 Surgical Cases in Cervical Disc Disease

Sung, Baek Kang; Kim, Tae Sung; Lim, Young Jin; Kim, Gook Ki; Rhee, Bong Arm; Leem, Won

Abstract

Cervical disc disease and spondylosis have troubled human beings since the earliest recording of human ailment, encountered in term of one's life and still is one of the most intricated neurosurgical disorders, although there are a good many kind of diagnostic and surgical advances. Cervical disc disease has been studied more extensively and also diagnostic studies have developed considerably in recent times including myelography, computerized tomographic scan and magnetic resonance imaging. The treatment for cervical disc disease may be medical, surgical, or both but surgery, is increasingly popular owing to development of microanatomy, pathology, diagnostic tools and microsurgery. The surgical approaches to cervical disc disease have developed as the clinical syndrome, mechanisms of disease, and pathological changes that ensue have been better defined. Dramatic result of posterior decompressive laminectomy was reported by Horsley in 1901 and modified by Scoville, Kahn, Fager, and others. The anterior approach to compressive lesions, a more recent development by Robinson in 1955, by Cloward in 1958, and Boldrey, has become increasingly popular. The anterolateral approach, offered by Verbiest in 1968, provided an third avenue to the pathological cervical disc disease. Surgical results for cervical root compression can be relieved well, but myelopathy responds less well to decompression, provided the preoperative diagnosis is accurate and the operation is done carefully from either anterior or posterior approach. The authors has reviewed 79 cases cervical disc disease which treated surgically in Kyung Hee Medical Center from March, 1984 to May, 1990, the result as follows: 1) Cervical disc disease were more frequently encountered between 5th and 6th decades(67%) and the ratio of male to female was 2:1. 2) The symptom onset was acute in 58% of patients but the causes could not define clearly in 76% of patients. 3) The most frequent clinical symptom was pain in the neck(88.6%). 4) The most frequent site of disc herniation was C5-6 level as a single lesion, but the multiple level was effected in 12.7% of patients. 5) Postoperative complications were occurred in 11.4% of patients. 6) The prognosis was influenced by age, sex, time interval between the symptom onset and operation, and direction and character of disc herniation.