A surgical technique for a vertebral column autograft using the intervertebral disc for cervical disc disease.

Abstract

We describe a surgical technique for a vertebral column autograft using the intervertebral disc for cervical disc disease for patients whose major problem is not spinal instability. Of a total of 41 patients with cervical disc disease suffering from cervical spondylotic radiculomyelopathy, 33 patients were operated on at one level and 8 patients were operated on at two levels. Postoperative X-ray film showed some movement at the "operated" disc level in all patients (average postoperative follow-up period was 43 months, range two years to 5 years). A significant decrease in motion in the extension position was observed postoperatively (p < 0.0001), but no significant difference was observed between the preoperative motion and the postoperative motion in the flexion position. Anterior angulation was found in two (5%) of the 41 patients. This surgical procedure has two major advantages: 1) no complications related to the iliac donor site, allowing early patient mobilization; 2) the extensive posterior spur can be removed safely and easily under a wide operative field. We believe that this surgical procedure is suitable for preserving the mobility of the spine and may avoid stress concentration at adjacent levels of the "operated" disc. However, in patients whose major problem is spinal instability, anterior cervical fusion should be performed.