Cervical spondylotic myelopathy: Indications for surgery and choice of operative approach

ABSTRACT

Cervical Spondylotic Myelopathy [CSM] is a common neurosurgical problem with varied clinical presentation and natural course. The surgical approach to the treatment of CSM has been controversial both clinically and in literature. We present here the operative results of 23 patients with CSM, 9 were operated through the anterior approach and 14 through the posterior approach. Immediate postoperative improvement was noted in 88% patients, operated by anterior approach, and 64% in patients operated by posterior approach. Anterior approach is recommended when there is anterior compression at one or two levels. We recommend posterior decompression where compression is at more than two levels, posteriorly situated and/or. associated with spinal stenosis