Cervical Disc Lesion at Multiple Levels : Anterior Approach without Instrumentation

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  • Hida Kazutoshi
    Department of Neurosurgery, University of Hokkaido School of Medicine
  • Iwasaki Yoshinobu
    Department of Neurosurgery, University of Hokkaido School of Medicine
  • Abe Hiroshi
    Department of Neurosurgery, University of Hokkaido School of Medicine

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  • 頸椎2〜3椎間障害に対する前方アプローチ : 特にinstrumentation不要の立場から

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The treatment of multi-level cervical spondylosis still remains still controversial. There are 2 main surgical procedures ; one is anterior decompression with fusion, and the other is posterior decompression. In most cases of cervical spondylosis or ossification of the posterior longitudinal ligament (OPLL), the cervical cord is compressed mainly ventrally. Therefore, the usual anterior approach is effective as an optimum surgical treatment except in cases of a narrow spinal canal. Recently, an anterior cervical plate has been used in cases of multi-level cervical spondylosis or OPLL. In this paper, we describe the indication of an anterior cervical plate and its potential problems. However, an anterior cervical plate is unnecessary in usual multi-level cervical spondylosis or OPLL because plate failure may arise in some cases. We should use an anterior cervical plate only in cases of cervical cord injury or metastatic tumor.

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