For single-level cervical radiculopathy due to a herniated disc, what is the common surgical solution?

• A. Laminectomy and fusion
• B. Anterior cervical discectomy and fusion
• C. Laminoplasty
• D. Foraminotomy

Answer: (B)

For single-level cervical radiculopathy from a herniated disc, the goal is direct decompression of the ventral nerve root and stabilization of the affected segment. Anterior cervical discectomy and fusion achieves this best: through an anterior approach, the surgeon directly removes the herniated disc material that is pressing on the nerve root and then places a graft or spacer with a plate to fuse the level. This combination relieves the nerve compression and prevents future instability or recurrent herniation at that exact level, which is especially important when the disc space collapse or degenerative changes are present.

Other posterior approaches exist but are not as well suited for a ventral, single-level compression from a disc. A laminectomy with fusion decompresses the spinal canal from the back and is more commonly used for multilevel disease or myelopathy, where compression affects the cord from multiple levels. Laminoplasty is another posterior option aimed at widening the canal for broader stenosis and is typically used in multilevel situations. Foraminotomy focuses on enlarging the neural foramen to relieve compression of the exiting nerve root and is chosen when stenosis is predominantly foraminal rather than ventral disc herniation.

So the anterior discectomy with fusion directly targets the offending ventral pathology, provides reliable decompression, and stabilizes the segment, making it the most appropriate choice for this scenario.