Introduction: The aim of our study is to evaluate the results and effectiveness oft his minimal invasive technique with or without interbody fat graft replacement in patients with cervical paramedian disc herniations.
Methods: This prospective observational study was undertaken for the analysis of 357 patients with cervical paramedian disc herniation who underwent one -or adjacent two-level anterior contralateral microdiskectomy without fusion between 1992 and 2010. Interbody fat graft replacement were performed on 114 of 357 patients (Group2). The mean follow up time was 10 years (range 1-17 years). Surgeries were done by the senior author (YA). Clinical outcomes were assessed using the Neck Disability Index (NDI) and Short Form-36 (SF-36 ).
Results: Despite fusion procedures were not performed, spontaneous radiological fusion signs were obtained in 12% of group 1 patients.Follow-up radiological studies revealed healing without fusion in group 2 patients. There was no significant change in the mean overall cervical curvature (C2 -7) angles postoperatively in late follow-up findings (p = 0.77). It represented a statistically significant mean loss of 2.24 degree of segmental lordosis (p < 0,0001). The NDI scores decreased significantly in both early and late follow-up evaluations and the SF-36 scores demonstrated significant improvement in late follow-up results in two groups. Analysis of clinical outcome showed no statistical differences between two groups (p = 0.77).
Conclusions: The goal of our technique is to reduce or eliminate adjacent segment disease by preventing collapse of the involved disk space and preserving motion at the treated level.
Patient Care: Contralateral approach and intervertebral fat graft prevents; adjacent segment disease, serious complications of the instrumentation, long term side effects of the foreign materials in body.
Learning Objectives: Our really minimal invasive technique provides;
better and direct exposure of the pathology,
preservation of motion segment (no functional loss),
going back to work in shorter time with short hospital stay, esthetic result, lower cost.