Evidence brief
Surgical Treatment of Cervical Spondylotic Myelopathy
Surgery effective for cervical spondylotic myelopathy
87% of patients improved after surgery
Approach (anterior vs posterior) based on pathology and alignment
Duration of symptoms impacts recovery
Multi-level disease may require combined approach
Surgery is effective for cervical myelopathy and prevents progression. Approach selection (ACDF, corpectomy, laminectomy, laminoplasty) depends on pathology location, number of levels, and cervical alignment.
Know approach selection: anterior for 1-2 levels, kyphosis; posterior for 3+ levels, preserved lordosis. Discuss laminectomy vs laminoplasty (latter preserves motion, prevents post-laminectomy kyphosis). Clinical findings: Hoffman's sign, gait changes, hand clumsiness.
Level II
Lesser quality RCT or prospective comparative study