Cervical myelopathy from disc herniation: when is surgery unavoidable?
0
OrthoVellum Editorial · 7d ago
Share
MRI of acute cervical disc herniation causing myelopathy — Credit: Westwick HJ et al. via Surg Neurol Int (Open-i (NIH)), CC BY
The AOSpine CSM study and subsequent analyses have shown that patients with mild myelopathy can remain stable for years with conservative management, while surgery offers faster recovery of function. But shared decision-making with patients is genuinely difficult when symptoms are intermittent — many are hesitant about an anterior cervical discectomy and fusion in their 50s. How are people counselling these patients, and are there specific clinical or radiological red flags that tip you firmly toward surgical recommendation?
