title: Cervical osteochondrosis and disc herniation. Eighteen years' use of interbody fusion by Cloward's technique in 755 cases.
abstract: Seven hundred and forty patients (mean age 51 years) underwent anterior cervical interbody fusion by the method of Cloward in an 18-year period because of cervical osteochondrosis/disc herniation. Fifty-nine needed re-spondylodesis (same or different level or levels in the period. Ninety-six percent presented with radicular symptoms or signs, or both, while seven percent presented with "long tract" symptoms and signs. Myelography was done in all cases except three. Kiel-surgibone was used in 83% of 560 one-level, 177 two-level, and 3 three-level fusions. Eighty-one percent reported total or partial relief of preoperative (predominantly redicular) symptoms and signs postoperatively, but ultimately (observation time 1-13 years) only 71% benefited with regard to neck pain, radicular brachialgia, and neuropathy, and only 42% of those with symptoms and signs of spinal cord compression benefited. Operative complication rate was 4%, and Kiel-surgibone graft problems occurred in 2% of 958 interbody fusions. Beneficial results could be related to short period of symptoms, free intraspinal disc fragments, and a cautious attitude to multi-level fusions. Cloward's interbody fusion is found to be reliable, but delineated attitude to the different types of alternative operations (disc resection, facetectomy or laminectomy) is emphasized.
mesh_terms: D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010007:Osteochondritis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods*