Cervical compressive myelopathy: surgical treatment

Indications for surgical treatment

• Progression of signs and symptoms
• Myelopathy present for ≥6 months
• Persistent radiculopathy unresponsive to physiotherapy and immobilization
• Compression ratio approaching 0.4
• Severe pain
• Severely impaired function
• Rapid deterioration
• Cord compression with progressive neurological deficit

Goals of surgery

Techniques

Outcome

Synonym

References

1. Law MD, Bernhardt M, White AA. Cervical spondylotic myelopathy: a review of surgical indications and decision making. Yale J Biol Med 1993; 66:165-177.
2. Emery SE. Cervical spondylotic myelopathy: diagnosis and treatment. J Am Acad Oryhop Surg 2001; 9:376-388.
3. McCormick WE, Steinmetz MP, Benzel EC. Cervical spondylotic myelopathy: make the difficult diagnosis, then refer for surgery. Cleve Clin J Med 2003; 70:899-904.
4. Komotar RJ, Mocco J, Kaiser MG. Surgical management of cervical myelopathy: indications and techniques for laminectomy and fusion. Spine J 2006; 6(Suppl):252S-267S.
5. Fouyas IP, Sandercock PAG, Statham PFX, Nikolaides I. How beneficial is surgery for cervical radiculopathy and myelopathy? BMJ 2010; 343:c3108.
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Related checklists

• Cervical compressive myelopathy: clinical features
• Cervical compressive myelopathy: non-surgical treatment