Anterior surgery for cervical disc disease. Part 1: Treatment of lateral cervical disc herniation in 253 cases.

Between 1971 and 1977, 334 patients at the Presbyterian-University Hospital underwent anterior surgery for treatment of hard or soft cervical disc herniation. Of these patients, 295 had radicular symptoms only. This retrospective study details the results of anterior cervical surgery for treatment of lateral disc herniation in 253 patients who survived 1 to 7 years postoperatively. Sixty-seven percent had excellent or good results. Although 77% initially noted complete relief of symptoms after surgery, 38% subsequently developed one or more recurrent symptoms at some time during the follow-up period. The overall results of surgery for soft disc cases were no different from the results for hard discs, although significantly more hard disc cases required postoperative conservative treatment. The results of surgery after anterior fusion were no different than the results after anterior discectomy alone. However, overall postoperative complications were more frequent and hospitalizations were longer in the patients who underwent fusion. Patients with multiple-level surgery had statistically similar results to those with single-level surgery. None of the nine preoperative clinical features reported by others to influence the results of anterior cervical surgery were found to consistently affect outcome in the present series.