Extruded cervical disc herniation: treatment with anterior microdiscectomy

Nine cases of extruded cervical disc herniation (7 with radiculopathy, 2 with acute myeloradiculopathy) were treated by radical anterior microdiscectomy, with opening of the posterior longitudinal ligament, removal of the extruded peridural disc material, bilateral resection of the posterior part of the uncovertebral joints; in 6 cases surgery was completed with Smith-Robinson intersomatic fusion. In all of the cases symptoms rapidly regressed, with considerable neurological recovery. There were no major complications in any of the cases, and 2-5 years after surgery results were evaluated as excellent in 7 cases and good in 2. The use of the operating microscope allows for removal of extruded disc herniations under magnification, in a bloodless surgical field and with no manipulation of the nervous structures. Because of these features, this method is preferred to traditional posterior surgery and anterior surgery without magnification.