The surgery of cervical disk disease: new perspectives

Current trends in the surgical treatment of cervical disk disease, when compared with those of the 1960s, have been unimpressive. There is an ongoing refinement of anterior procedures, which seem to be effective for both myelopathy and radiculopathy, ranging from simple diskectomy and/or fusion to variously radical anterior decompressions. This refinement has demonstrated that however simple or radical the anterior procedure is, the results seem to be the same and that bone grafting is not necessarily critical to success. Posterior procedures, both for root exploration and spinal cord decompression, have fewer advocates but remain important procedures. Their magnitude relative to that of anterior surgery and the lack of refinement of laminectomy over the past 50 years probably accounts most for the preference for anterior surgery. Anterior and posterior disk surgery both have their place based on a surgion's preference. One can expect 80 to 100% acceptable results with radiculopathy and 50 to 70% with myelopathy.