International Journal of Medical Sciences And Clinical Research
42
https://theusajournals.com/index.php/ijmscr
VOLUME
Vol.05 Issue06 2025
PAGE NO.
42-44
10.37547/ijmscr/Volume05Issue06-09
Advanced Surgical Approaches to Degenerative Cervical
Spine Disorders
Yuldashev Ravshan Muslimovich
Republican Scientific Center of Neurosurgery under the Ministry of Health of the Republic of Uzbekistan
Djumanov Kamaliddin Nuriddinovich
Republican Scientific Center of Neurosurgery under the Ministry of Health of the Republic of Uzbekistan
Shukurov Xumoyuddin Asliddin o’g’li
Republican Scientific Center of Neurosurgery under the Ministry of Health of the Republic of Uzbekistan
Ibragimov Akobir Ismailovich
Republican Scientific Center of Neurosurgery under the Ministry of Health of the Republic of Uzbekistan
Received:
30 April 2025;
Accepted:
28 May 2025;
Published:
30 June 2025
Abstract:
Degenerative diseases of the cervical spine are increasingly prevalent and present complex challenges
for treatment. This study analyzes clinical outcomes of 76 patients who underwent various surgical interventions,
including anterior discectomy, spondylodesis, laminoplasty, and decompressive laminectomy. The findings
suggest that timely surgical treatment significantly reduces pain, improves neurological function, and enhances
quality of life. Two-stage surgeries proved most effective for cases involving severe myelopathy and spinal
stenosis.
Keywords:
Cervical spine, disc herniation, laminoplasty, cervical spondylosis, radiculopathy, myelopathy, spinal
stenosis, discectomy, spondylodesis, neurological recovery.
Introduction:
Degenerative diseases of the spine are on
the rise worldwide, including in Uzbekistan. Cervical
spondylosis and intervertebral disc degeneration can
lead to radiculopathy or myelopathy due to progressive
stenosis of the spinal canal and deformation of the
interarticular surfaces. An epidemiologic study
conducted over 14 years in Rochester (Minnesota, USA)
showed that cervical radiculopathy is 83.2 cases per
100,000 population. Although conservative therapy is
effective in the majority of patients with degenerative
manifestations or disc herniation, many patients
require surgical treatment due to the progression of
symptoms or the ineffectiveness of conservative
treatment [1,2,9].
As is known, the spine is the basis of the
musculoskeletal system and, due to upright posture, is
regularly subjected to significant statodynamic loads.
Due to the above reason, dystrophic pathologies are
diagnosed relatively early in the spine. Vascular
obliteration of intervertebral discs noted in childhood
significantly aggravates degenerative processes. The
literature presents data that the genetic determinism
of intervertebral disc lesions often manifests in the
form of inherited collagen structure disorder. To a large
extent, the development of degenerative processes in
the spine is caused by injuries, as well as traumatic
disorders of statics, manifested in the form of limitation
of mobility in joints, diseases, and pathology of knee
and hip joints. A recent study shows that 79% of the
population aged 18-44 years have smartphones, and
practically all the time, the cervical spine is in an
involuntary physiologic position. Prolonged use of
smartphones and sitting at a computer directly affects
International Journal of Medical Sciences And Clinical Research
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International Journal of Medical Sciences And Clinical Research (ISSN: 2771-2265)
the cervical spine. Forward bending of the head is
reflected in varying degrees on the load on the spine -
when the head is bent forward at 15 degrees, the force
of the load on the neck is equal to 12kg, at 30 degrees,
18kg, at 45 degrees 22kg and at 60 degrees up to 27 kg,
at 90 degrees the model prediction was not reliable.
Prolonged use of smartphones, prolonged time spent
in front of the computer, and a sedentary lifestyle
usually cause neck pain and soreness - further, it all
leads to degenerative changes in the intervertebral
discs. Degenerative changes most often occur in the
cartilage structures of intervertebral discs and arch
joints, as evidenced by clinical signs of cervical
osteochondrosis and deforming spondylosis and
spondyloarthritis, often combined [4,6].
The objective of this study is to evaluate and enhance
the surgical management of degenerative diseases
affecting the cervical spine.
METHODS
This study included 76 patients who underwent surgical
treatment at the Republican Scientific Center of
Neurosurgery during the years 2022
–
2023 for
degenerative cervical spine diseases. The cohort
consisted of 29 females and 47 males, aged between 28
and 83 years (mean age: 53.8). All patients presented
with symptoms including neck pain, upper limb
numbness, muscle weakness, and limited mobility.
Neurological manifestations such as radiculopathy,
myelopathy, and in some cases, pelvic dysfunctions
were frequently observed.
Each patient underwent a comprehensive examination,
including neurological evaluation, functional spinal
radiography, magnetic resonance imaging (MRI),
computed
tomography
(CT),
and
electroneuromyography (ENMG). Multilevel spinal
compression was identified in 54% of cases, while
single-level disc herniations were noted in the
remainder, most commonly at C5-C6, C6-C7, and less
frequently C3-C4 levels.
Depending on the severity and level of the pathology,
patients underwent various procedures: anterior
discectomy with cage and plate fixation (Peek Cage,
Double Medical), posterior laminoplasty (Double
Medical), or decompressive laminectomy. In severe
cases with myelopathy and spinal stenosis, two-stage
surgeries were performed
—
posterior decompression
via laminoplasty followed by anterior discectomy with
cage-based spondylodesis.
RESULTS AND DISCUSSION
The analysis revealed that the majority of patients
(88%) experienced significant improvement in the
postoperative period. Pain intensity, measured using
the Visual Analog Scale (VAS), decreased from 7.0 to 2.0
in the cervical region and from 8.5 to 2.0 in the upper
limbs within 12 months of follow-up. Figure 1.
Figure 1. VAS score
International Journal of Medical Sciences And Clinical Research
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International Journal of Medical Sciences And Clinical Research (ISSN: 2771-2265)
In cases involving multilevel compression and
pronounced myelopathy, the best outcomes were
achieved through two-stage surgical interventions. This
approach confirms the necessity of comprehensive
treatment for complex degenerative pathologies.
Patients undergoing laminoplasty or laminectomy
showed notable recovery in sensory function, strength,
and range of motion in the limbs, as well as
improvement in pelvic organ function.
Complications were rare, with one case (1.3%) of spinal
cord edema and one fatal outcome in a patient
admitted in critical condition with severe tetraparesis
and
respiratory
dysfunction.
Overall,
surgical
management demonstrated strong clinical efficacy,
especially when timely and individually tailored.
CONCLUSION
In conclusion, surgical intervention is an effective
treatment strategy for degenerative cervical spine
diseases when conservative methods fail. The best
results are achieved through timely diagnosis and
appropriate surgical planning.
Anterior cervical discectomy and fusion (ACDF) remains
the gold standard for single-level disc herniations, while
multilevel stenosis and cases with myelopathy benefit
from posterior or combined approaches. Two-stage
surgeries offer the most comprehensive neurological
recovery
and
improved
quality
of
life.
A
multidisciplinary diagnostic and therapeutic approach
minimizes complications and substantially reduces
disability rates among patients
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