Cervical Spondylotic Myelopathy: Pathophysiology and Surgical Approaches

This paper reviews the pathophysiology of cervical spondylotic myelopathy (CSM) and several surgical approaches for the treatment of CSM. CSM is a degenerative disease with severe morbidity. The pathophysiology of CSM involves static, dynamic, and ischemic factors. The management of mild CSM typically involves conservative treatments and medication; whereas, moderate and severe CSM are better treated surgically. Surgical treatments for CSM are basically classified into anterior and posterior surgeries. The common techniques are anterior cervical discectomy and fusion (ACDF), anterior cervical corpectomy and fusion (ACCF), laminectomy, and laminoplasty. Each technique has its own advantages and disadvantages. In this paper, we review the research papers from PubMed database to elaborate the advantages and disadvantages of each technique.