[Surgical treatment of the herniated cervical disc--a consideration on the choice of operative method following our experience with 200 patients].

There is a controversy on the surgical treatment for the so-called cervical herniated disc. Recently operators choosing the anterior approach have increased in more and more. However, considering the historical view of the treatment of disc disease, it is obvious that the posterior approach is also an important method, especially in the cases combined with the stenotic cervical spinal canal. During the past five years 200 patients of cervical herniated disc disease were operated in our clinic by using our newly devised instruments and new materials. We studied the relation between the operative approach, the extent of interbody fusion and the surgical results. The social adaptation of the operated patients was also examined especially by comparing the short follow-up with the long one. Regardless of surgical approach, the percentage of the good recovery is higher (10% at the most) in the short follow-up than that in the long observation. The consequence is thought to show that the social adaptation deteriorates as the time goes on. Based on these results, the historical aspects and the technical problems of anterior and posterior approach were reviewed, focusing especially the controversial points. On the other hand, presenting our opinion on the surgical approach, we showed how the surgical problems have been solved and other complications lowered by introducing our new technique. Consequently, we stress that it is insignificant to discuss whether we should choose the anterior approach or the posterior approach. Finally, in case of criticizing the surgical results, it is reemphasized that we should think over not only the simple operative results, but also the aspect of social adaptation.