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William B. Scoville, MD

JAMA. 1966;196(6):479-481.

Abstract
Cervical disk lesions fall into five distinct categories differing widely in numerical composition, in symptomatology, and in operative approaches. Lateral disk lesions constitute 95% of all operable lesions and simple "keyhole" facetectomy or foraminotomy with slow and high-speed drills constitutes the treatment of choice. Central ridge or bar defects, misnamed "spondylosis," may be approached by either the anterior or posterior approach, providing decompression from the infolded ligamentum flavum, the calcified central ridge, and the lateral osteophytes. Central soft disk lesions are so rare as to constitute only 1% of cervical disk surgery. They should be approached anteriorly but the posterior combined intradural and extradural approach is advocated when there is need to differentiate from a tumor. Patients with fracture-dislocations with disk protrusion should be operated on through an anterior approach. There is rarely improvement, but it is occasionally advocated to permit earlier rehabilitation.

Author Affiliations
From the Department of Neurosurgery, Hartford Hospital, Hartford, Conn.

Footnotes
Read before the Third World Congress of Neurological Surgery, Copenhagen, Aug 26, 1965.

Reprint requests to 85 Jefferson St, Hartford, Conn 06103.

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