Surgical management of cervical disc disease: from no fusion to fusion and back again.

Early surgical treatment of the cervical spine for neural decompression used the posterior approach to perform cervical laminectomies for trauma and degenerative disease (44, 60, 88). Scoville et al. (72) and Frykholm (31) refined the posterior cervical approach for degenerative disc disease and introduced the laminoforaminotomy technique. About 20 years later, a number of surgeons introduced anterior cervical discectomy with fusion (ACDF) for degenerative disc disease. Robinson et al. (67), Dereymaeker and Mulier (25), and Baily and Badgley (8) recommended fusion of the involved segment without decompression of the spinal canal from dorsal osteophytes. After immobilization of the degenerated segment, resorption of dorsal osteophytes was documented (67). In 1958, Cloward (20) first introduced the concept of ACD without fusion and direct surgical decompression of dorsal osteophytes. About the same time, the concept of ACD without fusion was successfully applied (43).