Cervical Intervertebral Disc Degeneration – Surgical Treatment Indications and Options


Authors: P. Suchomel
Authors‘ workplace: Neurochirurgické oddělení, Neurocentrum, Krajská nemocnice Liberec a. s.
Published in: Cesk Slov Neurol N 2008; 71/104(3): 246-261
Category: Minimonography

Overview

There are a growing number of patients presenting with complaints related to pain in the cervical spine. In order to discover the underlying causes, both the acquired clinical knowledge and a number of modern examination methods are utilised. Usually, the cause resides in a degenerative disease, and if the patient is not affected by a significant or progressing neurological deficit, conservative therapy should be applied. In the opposite case, or if conservative therapy proves ineffective, surgery is considered as a therapeutic option. The objective of the overview article is to describe pathological conditions related to cervical intervertebral disc degeneration, to systematize their morphological diagnosis and to provide the reader with clear guidelines for the selection of patients who could benefit from surgical intervention. The subsequent section pursues the objective of describing, in simple terms, current methods of surgical treatment of cervical intervertebral space. Each of the procedures described therein has its strong and weak points. None of the methods described is endorsed by the necessary body of evidence in relevant literature and similar results can be expected from the application of any one of them. However, the basic prerequisites are correct indication based on the harmony of clinical and morphological findings and excellence of surgical technique. Of equal importance is long-term follow-up of patients and standardized evaluation of the results of the surgeons' efforts. The doctor sending his or her patient for surgery should always know what the results of the surgery team have been, and should be in permanent contact with them. Experience in performing similar procedures and adequate equipment of the centre should be another criterion for successful cooperation. The Czech Spine Surgery Society JEP monitors on a long-term basis the parametres of the different spine surgery centres and classifies their performance. For better orientation among spine surgery centres, the referring neurologist, orthopaedist or rehabilitation specialist can use the database of approved spine surgery centres published at www.spine.cz on an annual basis.

Key words:
cervical spine – degenerative disease – cervical spine surgery – discectomy


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