Cervical spondylotic myelopathy: The role of posterior decompression, arthrodesis, and instrumentation

Abstract

Cervical spondylotic myelopathy (CSM) is an insidious, progressive disease process that presents with a number of symptoms frequently refractory to conservative non-operative treatments that often require operative intervention. Nevertheless, controversy exists over the optimal choice of surgical treatment for CSM. For patients with progressive symptoms despite nonoperative therapy, posterior decompression is an appropriate treatment option dependent upon location of pathology, extent of degenerative disease, and cervical alignment. Fusion and instrumentation is a further adjunct to posterior cervical decompression and has gained popularity as a method of maintaining cervical spine stability and alignment following decompression.