Transdural approach to the anterior spinal canal in patients with cervical spondylotic myelopathy and superimposed central soft disc herniation.

We present seven patients with multilevel cervical spondylotic myelopathy and superimposed midline soft disc herniation who were treated by decompressive laminectomies of the spondylotic segments followed by transdural excision of the anteriorly located disc extrusion. There was no perioperative neurological morbidity or mortality associated with this operation, and no patients have developed postoperative kyphotic deformity with an average follow-up of 50.1 months (range, 24 to 87 mo). Two patients had full neurological recovery, whereas five patients had improvement in their preoperative neurological status. We conclude that a posterior transdural approach may offer an alternative surgical option for select patients with multilevel cervical spondylosis with superimposed midline soft disc herniation in whom multiple segment decompression plus access to the anterior spinal canal is necessary.