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Cervical osteochondrosis and disc herniation. Eighteen years' use of interbody fusion by Cloward's technique in 755 cases

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Summary

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 delinated attitude to the different types of alternative operations (disc resection, facetectomy or laminectomy) is emphasized.

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  1. C. Mosdal

    Present address: Department of Neurosurgery, Odense University Hospital, Odense, Denmark

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    1. C. Mosdal
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    Mosdal, C. Cervical osteochondrosis and disc herniation. Eighteen years' use of interbody fusion by Cloward's technique in 755 cases. Acta neurochir 70, 207–225 (1984). https://doi.org/10.1007/BF01406650

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