The surgical technique for anterior surgery to treat a herniated disc in the cervical spine was described by Cloward R. in 1958[^1].
Anterior cervical discectomy (ACD)
The Anterior Approach for Removal of Ruptured Cervical Disks
Evidence brief
Bottom line
Cloward’s 1958 paper described anterior cervical discectomy followed by vertebral-body fusion in detail, establishing a key technical foundation of modern anterior cervical spine surgery.
Editorially appraised and medically reviewed
Study profile
- Design
- Technical historical paper
- Year
- 1958
- Journal
- Journal of Neurosurgery
The clinical question
Study question
How can a ruptured cervical disk be removed through an anterior approach and the spine subsequently fused with an interbody graft?
PICO framework
What was compared?
- Population
- Patients with symptomatic ruptured or degenerative cervical disks whose symptoms had not been adequately relieved by conservative treatment.
- Intervention
- Anterior cervical discectomy with direct decompression followed by interbody fusion using a bone dowel graft.
Decision-relevant results
Key outcomes
Technical contribution
1958
Detailed description of the anterior exposure, disk removal, and vertebral-body fusion, including the rationale and operative instruments.
Original material
Study context and original material
Additional editorial context, figures, and the study authors’ conclusion documented in the article.
Editorial appraisal
Interpretation for practice
Significance
Clinical relevance
The publication is important primarily for its historical and technical influence. It established a direct anterior route for decompression without approaching the disk through a posterior corridor around the spinal cord and nerve roots.
Context
Key limitations
This is a historical technical case series without a randomized comparator or modern standardized outcomes. Its reported experience should not be read as comparative evidence for contemporary implants or procedural variants.