Context Cervical myelopathy occurs as a result of compression of the cervical spinal cord. Symptomatology includes, but is not limited to, pain, weakness, paresthesias, or gait/balance difficulties. Objective To present a two-decade experience with the management of cervical myelopathy. Methods Literature was reviewed to provide current guidelines for management as well as accompanying clinical presentations. Results Surgical decompression, if necessary, may be achieved from either an anterior, a posterior, or a combined anterior-posterior (AP) approach. The indications for each approach, as well as the surgical techniques, are described. Conclusion Several etiologies may lead to cord compression and cervical myelopathy. The best vector of approach with regard to anterior versus posterior surgical intervention is still under investigation. Regardless, management via surgical decompression has been demonstrated repeatedly to improve the CSM patients' quality of life.
Keywords: Anterior cervical decompression and fusion; Cervical myelopathy; Laminoplasty; Posterior cervical decompression and fusion; Sagittal alignment.