Reappraisal of the posterior approach for cervical decompressive herniectomy

J Neurosurg Sci. 2019 Feb;63(1):30-35. doi: 10.23736/S0390-5616.16.03774-7. Epub 2016 Jul 7.

Abstract

Background: Does posterior cervical herniectomy impact on symptoms related to cervical paramedian/lateral soft disc herniation?

Methods: In a patient series over 15 years operated for single level paramedian/lateral soft disc herniation with posterior cervical approach, perceived radicular and cervical pre- and postoperative symptoms were reconstructed and analyzed.

Results: Out of 105 patients with these characteristics 75 could be recruited for long-term follow-up. Preoperative symptoms included: radicular motor deficit (81.3%); radicular pain (93.3%); radicular sensory deficit (84%); cervical pain (80%) and disturbance of cervical motility (49.3%). Postoperatively radicular motor score improved in all patients (score 5 in 92% and 4 in 8%); sensory disturbance improved in all and radicular pain disappeared in 90% and improved in the others. Cervical pain disappeared in 78% and improved in other 22%, two had new onset moderate cervical pain.

Conclusions: This series confirms safety and efficacy of the posterior approach in relieving motor and sensory symptoms in patients with symptomatic single level, lateral soft disc herniation.

MeSH terms

  • Adult
  • Decompression, Surgical / adverse effects
  • Decompression, Surgical / methods*
  • Diskectomy / adverse effects
  • Diskectomy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Intervertebral Disc Displacement / complications
  • Intervertebral Disc Displacement / physiopathology
  • Intervertebral Disc Displacement / surgery*
  • Male
  • Middle Aged
  • Outcome and Process Assessment, Health Care*
  • Pain / etiology
  • Pain / surgery*