Anterior Surgery of Hard and Soft Cervical Disc

Abstract
Background: Anterior access cervical surgery aims to remove the compressing agent which might be soft disc material or bony spur this offender material is the cause of patient complaint which might be electrical like pain or, numbness in one upper limb or both.
Anterior cervical surgery of hard & soft disc aims towards the excision of the bony osteophyte or disc material that is compressing the nerve root causing "electrical," "numbness," or "shooting" pain, that often begins in the neck & travels into one or both shoulders and arms.
Aim of Study: To compare the results of ACDF using cages for interbody fusion in both soft and hard cervical discs extractions regarding the difference in surgical time, loss of blood, post-operative hospital stay, relief of presenting symp-toms, the incidence of complications & return to regular work.
Patients and Methods: This is a, retrospective. Study of 21 patients with the diagnosis of cervical disc prolapse operated upon by ACDF with cages instrumentation in the period from 5/2012-5/2015 in the Department of Neurosurgery, Beni Sueif University.
Cases were divided, into 2 groups:
•Group A: 14 patients with (single/double) levels soft cervical discs.
•Group B: 7 patients with (single/double) levels hard cervical discs.
Results: 21 cases were included in this series. The mean age was 35 in group (A) and 49 in group (B), there were six females, and 15 were males. 14 patients had single level discs, and seven patients had two levels.
Operative time was to some extent longer in hard disc cases than soft disc cases. Also, blood loss was somewhat more in hard disc than soft disc patient satisfaction is equal in the two groups; but return to regular work was after eight weeks in the hard disc in comparison to 6 weeks in soft disc period of follow-up was six month of both groups showing no difference in the outcome.
Conclusion: Although ACDF for hard cervical discs requires longer, operative time and may cause more loss of blood & more delayed return to regular work when compared to the soft discs, the clinical outcome during six months follow-up period showed no difference between the 2 groups.