Surgical Treatment of Cervical Spondylotic Myelopathy

Abstract

Cervical spondylotic myelopathy is a progressive degenerative cervical spine disease common in adults over the age of 55 years. As the size of the aging population continues to grow, a higher incidence of cervical myelopathy will be seen in the elderly population. Surgical treatment is often used to prevent further deterioration and permit neurological recovery in symptomatic cases. Ventral approaches include anterior cervical discectomy and fusion, anterior corpectomy and fusion, and cervical arthroplasty. Dorsal approaches involve laminectomy, laminectomy and fusion, and laminoplasty. Preoperative evaluation and optimization can reduce intraoperative and postoperative complications. Upcoming randomized trials will improve our understanding of which surgical approach is most effective in the treatment of CSM and which approach might be associated with fewer complications.