SummeryThis work included 30 patients with clinically and radiologically confirmed degenerative cervical disc disease and received surgical treatment. The aim of this work was directed at evaluations of surgical treatment in management of patients with degenerative cervical disc disease.The results were as follow:I- The age incidence ranged from 26-69 years.II- Pathology: patients of cervical disc disease have beencategorized into 4 groups according to pathology.A) Unilateral soft disc protrusion with nerve rootcompression.B) Foraminal spur, or hard disc, with nerve root compression.C) Medial soft disc protrusion with spinal cord compression.D) Transverse ridge or cervical spondylosis with spinal cordcompression - soft disc herniations usually affect onelevel whears hard disc can be multiple.III- Clinical picture: According to clinical presentation patientswere classified in to 2 groups.1) Group (A) with radiculopathy (21cases).2) Group (B) with myelopathy (9cases).(A) Radicolopathic group (21 patients):1- Onset: 8 patients had acute onset, 11 patients had insidiousonset and 2 patients had acute on top of chronic onset.2- Radicular pain was the initial symptom in all cases.3- Radicular numbness was present in all cases.4- Neck pain was present in all cases.5- The patients were classified according to the clinical course into 3 groups.Progressive - radicular pain (66.7 %).Stationary - radicular pain with recurrent exacerbation(14,3 %).Intermittent - radicular pain with progressive neurologicaldeficit (19 %).6- The duration of symptoms ranged from 4 week to 49 weeks.(B) Myelopathic group (9 patients):1- Onset: 2 patients had acute onset, 5 patients had insidiousonset, 2 patients had acute on top of chronic onset2- Course: One patient had stationary course, two patients hadintermittent course, six patients had progressive course.3- Duration of symptom: raged from 3 week to 19 week withmean duration was (11).4- Severity of the disease: according to Nurick’s gradingsystem of myelopathy (44.4%) were present in grade (I)(22.2 %) were present in grade (II) (22.2 %) were present ingrade (III) and (11.1%) were present in grade IV5- Sphincteric dysfunction: (55.6 %) were present In grade (III)(22.2 %) were present in grade (II) (22.2%) were present ingrade (I) No patient was present in grade (0).IV- Radiological evaluation: roentgen x ray & M.R.I were theroutine investigation in evaluation in cases of degenerativecervical disc disease for:a) Detection of ostephyte formationb) Confirmation of disc herniationc) Determination of the level of disc herniationC4-5 6C5-6 15C6-7 9V- Surgical treatment:A) Anterior cervical disectomy was performed in (96.97%) ofcases: single level (83.33%), double level (16.67%).B) Disectomy with bone graft and fixation using plate andscrews in (3.33%) of cases. Posterior longitudinal ligamentwas intact in 86.66% of cases posterior longitudinalligament was incised in 13.33% of cases.VI- Complication:- Seven cases had transient dysphagia- One patient had superficial wound infection- One patient had urinary tract infection.VII- Outcomes:A) In Radiclopathic group: excellent, outcome was noted in(19%) of cases and good outcome was present in (61.9%)of cases.B) In Myelopathic group: no patient was present in theexcellent, group and (44.4%) had good outcome.ConclusionDiagnosis of degenerative cervical disc disease depends on the clinical basis and magnetic resonance image. CT images of the cervical spine can be difficult for two reasons. First, the shoulders can often produce strip shaped artifacts in the cervicothrocic spines. Second, the epidural space is poorly visualized. This is due to the fact that the cervical dural sac is directly adjacent to the bone in contrast to lumber spine. It is not possible to diagnose a suspected prolapsed disc on the basis of the obliterated epidural space.Anterior cervical descectomy is usually sufficient method of surgical treatment in most cases of degenerative cervical disc disease.Anterior cervical descectomy with bone graft fusion is needed only in cases in which marked bone is removedMyelopathic cervical disc disease is absolute indication for surgery.All efforts should be directed toward early detection of cases with cervical disc herniation and early surgery is indicated before development of severe root or cord dysfunction.