Background. This article describes the diagnosis and surgical management of disk herniations and cervical spondylosis using Tibone implants. The aim of the study was to answer the question: Is decompression and interbody fusion at one clinically active level enough to provide a good outcome, or is it necessary to extend the operative procedure in the presence of multisegmental lesions in order to avoid symptoms from other levels? Material and methods. We studied 42 consecutive patients operated from 1999 to 2002 by means of decompression and anterior interbody fusion using Tibone implants. Results. The outcome was good in 32 cases (76.2%), satisfactory in 8 cases (19%), and poor in 2 cases (4.8%). Conclusions. The results we obtained indicate that precise clinical examination is crucial in determining the level and extent of surgery required. The comparison of data from x-rays and MRI images and a clinical investigation are required to make the decision whether or not to operate. The presence of lesions in x-rays and MRI images at levels other than those clinically active is not a sufficient indication for decompression and fusion at these levels.
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