Results of Anterior Cervical Discectomy without Interbody Fusion

Anterior cervical discectomy with or without interbody fusion has been conventionally used to treat patients with cervical disc diseases. However, discectomy without bone fusion has been abandoned due to the feat of early collapse of interbody space and recurrency. The author has analysed twenty-two cases of microsurgical cervical discectomy without bone fusion between Jan. 1993 and Mar. 1994. All patients were followed up for more than 6 months or as long as 21 months with repeat interview, physical examination, and radiological evaluation. The analysis revealed that the results were highly satisfactory in 21 cases with radiculopathies in terms of early ambulation, no discomfort in the iliac bone, and shorter hospital stay, but unsatisfactory in one cases which needed reoperation due to postoperative scar. The above method which had demonstrated promising results is recommended for the patients suffering from radiculopathy.

Anatomicophysiologic Monitoring in the Surgery of Central Area

In the surgery of central area, identifying the motor cortex in front of central sulcus is imperative to prevent loss of motor function. Twenty five patients with tumors or intractable epilepsy near the central sulcus were operated on at the Department of Neurosurgery of Chonbuk National University Hospital, from September. 1991 to December 1993. An estimated localization of lesions was performed with Callosal Grid System, which is a methodolgy made available by the development of high quality of magnetic resonance imaging, digital subtraction angiography and high resolution computerized tomography. This system allowed us to be oriented to the motor cortex as well as permitted assessment of the extent of resection. This was further delineated by direct electrical stimulation, which confirmed the functional motor cortex and made it possible to maximized the tumor resection near and in the motor cortex. The combination of direct cortical stimulation(functional mapping) and the use of the Callosal Grid System(anatomical mapping) allowed us to identify the spatial relationship between them as well as to maximize the tumor resection in most cases without injury to the central area, so that the better outcome is guaranted.