Skip to main content
SpringerLink
Log in

Anterior fusion for cervical spondylosis

  • Original Investigations
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Summary

Anterior fusion was performed on 138 patients as treatment for degenerative changes of the cervical vertebral column. The results were checked after up to 11 years in 122 patients and were found to be good in 55%, fair in 38.5% and poor in 6.5%. There were complications of phonetic paralysis in one case, Horner syndrome in two cases, 2 wound infections, and complaints about the iliac crest in 3 patients. Kyphosis at the fused segment occurred 26.1% of cases, the average angle being 15.3°, but it did not influence the clinical results. Mortality was 2%. Inadequate visualization of the nerve roots at operation was probably the reason for the segmental deficits and suggestions were made to avoid this by EMG, microsurgical technic, uncusectomy and hemifacetectomy. The results in the presence of myelopathy were much poorer, presumably because of associated degenerative changes in the older patients.

Zusammenfassung

138 Patienten mit degenerativen Veränderungen der Halswirbelsäule wurden durch die vordere Fusion behandelt. Bei Nachuntersuchungszeiten bis zu 11 Jahren konnten die Ergebnisse bei 122 Patienten überprüft werden. 55% waren gebessert, 38,5% unverändert, 6,5% verschlechtert. Komplikationen waren Stimmbandlähmungen (1), Hornersyndrom (2), Wundinfektion (2) und Beschwerden am Beckenkamm in 3 Fällen. Die Letalität betrug 2%. Winkelbildung im fusionierten Bewegungssegment trat in 26,1% der Fälle auf. Der Durchschnittswinkel betrug 15,3%. Es bestand kein Einfluß der Kyphose auf die klinischen Ergebnisse. Diskussion der Gründe für die nicht voll befriedigenden Ergebnisse bei segmentalen Ausfällen, möglicherweise bedingt durch nicht immer ausreichende intraoperative Darstellung der Nervenwurzeln. Anregung zu weiterer Differenzierung der Ausfälle mit Hilfe des EMG, zu größerer Beachtung der mikrochirurgischen Technik, der Uncusektomie (Jung), der Facetektomie nach Frykholm. Gründe für schlechtere Ergebnisse bei Myelopathie durch Anteil von Systemerkrankungen im Krankengut und durch ungeklärte Myelopathien bei gleichzeitiger zervikaler Spondylosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Abbott, K. H.: Anterior cervical disc removal and interbody fusion. A preliminary review of 101 patients followed for one to three years. Bull. Los Angeles neurol. Soc. 28, 251–259 (1963)

    Google Scholar 

  • Andrews, E. T., Gentchos, E. J., Beller, M. L.: Results of anterior cervical spine fusion done at the hospital of the university of Pennsylvania. A nine year follow-up. Clin. Orthop. 33, 15–20 (1971)

    Google Scholar 

  • Aaronson, N., Filtzer, D. L., Bagan, M.: Anterior cervical fusion by the Smith-Robinson approach. J. Neurosurg. 29, 397–404 (1968)

    Google Scholar 

  • Bailey, R. W., Badgley, C. E.: Stabilisation of the cervical spine by anterior fusion. J. Bone Jt. Surg. 42-A, 565–594 (1960)

    Google Scholar 

  • Busch, G., Schürmann, K., Samii, M.: First experiences with the anterior discectomy without fusion of the cervical spine in cases of acute disc rupture. Advances in Neurosurgery 3, pp. 357–363. Berlin-Heidelberg-New York: Springer 1975

    Google Scholar 

  • Caron, J. P., Cophignon, J., Hurth, M., Henrard, J. C., Julian, H., Tayon, B.: Le traitement chirurgical des radiculopathies cervicales d'origine discopathique par abord anterolateral. Rev. Rhum. 39, 359–371 (1972)

    Google Scholar 

  • Cauchoix, J., Binet, J. P.: Anterior surgical approaches to the spine. Ann. roy. Coll. Surg. Engl. 21, 237–243 (1957)

    Google Scholar 

  • Cloward, R. B.: The anterior approach for removal of ruptured cervical disc. J. Neurosurg. 15, 602–617 (1958)

    Google Scholar 

  • Connolly, E. S., Seymour, R. J., Adams, J. E.: Clinical evaluation of anterior cervical fusion for degenerative cervical disc disease. J. Neurosurg. 23, 431–437 (1965)

    Google Scholar 

  • Decking, D.: Restbeschwerden nach vorderer Spondylodese der Halswirbelsäule nach Cloward. Z. Orthop. 112, 752–753 (1974)

    Google Scholar 

  • De Palma, A. F., Cooke, A. J.: Results of anterior interbody fusion of the cervical spine. Clin. Orthop. 60, 169–185 (1968)

    Google Scholar 

  • Dereymaeker, A., Muller, J.: Nouvelle cure chirurgicale des discopathies cervicales. La ménisectomie par voie ventrale suivie d'arthrodèse par greffe intercorporéale. Neurochirurgie 2, 233–234 (1956)

    Google Scholar 

  • Dereymaeker, A., Ghosez, J. P., Henkes, R.: Le traitement chirurgical de la discopathie cervicale. Résultats comparés de l'abord postérieur (laminectomie) et de l'abord ventral (fusion corporéale), dans une cinquantaine de cas personnels. Neurochirurgie 9, 13–20 (1963)

    Google Scholar 

  • Frykholm, R.: Die cervicalen Bandscheibenschäden. In: Olivecrona, H., W. Tönnis: Handbuch der Neurochirurgie, Bd. 7, 1, p. 136f. Berlin-Heidelberg-New York: Springer 1969

    Google Scholar 

  • Galera, G. R., Tovi, D.: Anterior disc excision with interbody fusion in cervical spondylotic myelopathy and rhizopathy. J. Neurosurg. 28, 305–310 (1968)

    Google Scholar 

  • Grote, W.: Ventral fusion. Proceedings of the German society for Neurosurgery, Vol. 2, pp. 355–360. Amsterdam: Excerpta medica 1971

    Google Scholar 

  • Grote, W., Bettag, W., Wüllenweber, R.: Indikationen, Technik und Ergebnisse zervikaler Fusionen. Acta neurochir. (Wien) 22, 1–27 (1970)

    Google Scholar 

  • Grote, W., Röttgen, P.: Die ventrale Fusion bei der cervicalen Osteochondrose und ihre Behandlungsergebnisse. Acta neurochir. (Wien) 16, 218–240 (1967)

    Google Scholar 

  • Grote, W., Wappenschmidt, J.: Über Technik und Indikationen zur zervikalen Diskographie. Fortschr. Röntgenstr. 106, 721–727 (1967)

    Google Scholar 

  • Guidetti, B., Fortuna, A.: Long-term results of surgical treatment of Myelopathie due to cervical spondylosis. J. Neurosurg. 30, 714–721 (1969)

    Google Scholar 

  • Hankinson, H. L., Wilson, D. H.: Use of the operating microscope in anterior cervical discectomy without fusion. J. Neurosurg. 43, 452–456 (1975)

    Google Scholar 

  • Herzberger, E. E., Kindschi, L. G., Bear, N. E., Chandler, A.: Treatment of cervical disc disease and cervical spinal injury by anterior interbody fusion. A report on early results in 72 cases. Zbl. Neurochir. 23, 215–227 (1963)

    Google Scholar 

  • Hult, L.: Antero-lateral diskutrymning vid cervicala diskbrack. Nordisk Med. 60, 969–970 (1958)

    Google Scholar 

  • Jung, A., Vierling, J. P., Safaoui, A.: Douze cas d'arthrose cervicale inférieure. Leur traitement chirurgical par abord antérieur avec ouverture du trou transversaire et uncusectomie. La presse medicale 55, 3367–3372 (1964)

    Google Scholar 

  • Krayenbühl, H.: Die ventrale Operationsmethode von Cloward zur Exstirpation zervikaler Diskushernien. Ther. Umsch. 20, 444–447 (1963)

    Google Scholar 

  • Martins, A.: Anterior cervical discectomy with and without interbody bone graft. J. Neurosurg. 44, 290–295 (1976)

    Google Scholar 

  • Mayfield, F. H.: Cervical spondylosis: a comparison of the anterior and posterior approaches. Clin. Neurosurg. 13, 181–188 (1966)

    Google Scholar 

  • Mumenthaler, M.: Neurologie, 4. Aufl., S. 293. Stuttgart: Thieme 1973

    Google Scholar 

  • Murphy, M. G., Gado, M.: Anterior cervical discectomy without interbody bone graft. J. Neurosurg. 37, 71–74 (1972)

    Google Scholar 

  • Riley, L. H., Robinson, R. A., Johnson, K. A., Walker, A. E.: The result of anterior interbody fusion of the cervical spine. Review of ninety-three consecutive cases. J. Neurosurg. 30, 127–133 (1969)

    Google Scholar 

  • Robinson, R. A., Smith, G. W.: Anterolateral cervical disc removal and interbody fusion for cervical disc syndrome. Johns Hopk. Hosp. Bull. 96, 223–224 (1955)

    Google Scholar 

  • Robinson, R. A., Walker, A. E., Ferlic, D. C., Wiecking, D. K.: The results of anterior interbody fusion of the cervical spine. J. Bone Jt. Surg. 44-A, 1569–1587 (1962)

    Google Scholar 

  • Schürmann, K., Busch, G.: Die Behandlung der zervikalen Luxationsfrakturen durch die ventrale Fusion. Chirurg. 41, 225–228 (1970)

    Google Scholar 

  • Southwick, O., Robinson, R. A.: Surgical approaches to the vertebral bodies in the cervical and lumbar regions. J. Bone Jt. Surg. 39, 631–644 (1957)

    Google Scholar 

  • White, A. A., Southwick, W. O., Deponte, R. J., Gaynor, J. W., Hardy, R.: Relief of pain by anterior cervical spine fusion for spondylosis. J. Bone Jt. Surg. 55-A, 525–534 (1973)

    Google Scholar 

  • Wilson, D. H., Campbell, D. D.: Anterior cervical discectomy without bone graft. Report of 71 cases. J. Neurosurg. 47, 551–555 (1977)

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Neurochirurgische Klinik der Johannes-Gutenberg-Universität Mainz, Langenbeckstr. 1, D-6500, Mainz, Federal Republic of Germany

    Günter Busch

Authors
  1. Günter Busch
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Busch, G. Anterior fusion for cervical spondylosis. J. Neurol. 219, 117–126 (1978). https://doi.org/10.1007/BF00314394

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00314394

Key words

Search

Navigation