Anterior cervical decompression technique via intervertebral space under microscope / 第二军医大学学报

ABSTRACT

Objective To discuss the technique of the anterior cervical decompression via intervertebral space under microscope. Methods A total of 271 patients with cervical disc herniation underwent anterior microsurgical decompression and intervertebral fusion from Jun. 2000.6 to Dec. 2005. The patients included 178 cases with single level herniation, 71 with double level ones, and 22 with three level ones. MRI images showed slight or medium anterior compression with slight abnormal changes within spinal cord in all cases. The main equipment included operation microscope for neurosurgery and high speed bur. The annular fibrous and osteophytes were removed by high speed bur to expose and clean the degenerative nucleus pulpous. We lifted the posterior longitudinal ligament (PLL) with tension using a hook-like stripper and cut it; then the residual PLL and posterior bony edges were removed. Results There were no severe complications such as injuries of the spinal cord, nerve root or blood vessels. The average intraoperative blood loss was (126 + 29. 4) ml and the mean operative time was (62+12. 4) min. The average time for the patients to get off bed was (1. 8 + 0. 4) days. The nerve functions were improved in all patients after operation, with the excellent nerve function found in 69 cases, good in 157 cases, fair in 27 cases, and poor in 18 cases according to JOA scores. Conclusion Anterior cervical decompression via intervertebral space under microscope is suitable for treatment of pathological changes of the intervertebral space; delicate manipulation under microscope and high speed bur can contribute to a successful operation; and the anatomy of intervertebral space is more suitable for the biomechanics of the cervical vertebrate.