Indications for and volume of anterior decompression of the spinal cord in injuries of the cervical spine

Analysis of surgical management of 113 patients (92 in the acute period of the injury and 21 in the late period) with closed injury to the cervical segment of the spine and spinal cord made it possible to elaborate strict indications for and determine the volume of anterior decompression of the spinal cord. The principal indication for operation through an anterior approach in the acute period of injury to the cervical spine is anterior compression of the spinal cord caused by different factors identified by detailed X-ray examination including methods of contrast study (warm venospondylography, pneumomyelography, discography, vertebral angiography). In 34 patients the spinal cord was examined by the microsurgical method with removal of the responsible factors. With the use of this method, lethality reduced to 4.3% and the conduction functions of the spinal cord were restored in 72.8% of the patients in the acute period and in two thirds of the patients operated on in the late period.