Asian Journal of Orthopaedic Research

Cervical spondylotic myelopathy (CSM), also known as degenerative cervical myelopathy, is a progressive spinal disorder caused by vertebral canal narrowing and spinal cord compression. It is commonly associated with degenerative disc disease, cervical osteoarthritis, spondylolisthesis, and ligament hypertrophy or ossification. Epidemiological studies report high prevalence rates, particularly in older populations, with variations across different regions. Pathophysiology involves static and dynamic compression mechanisms, vascular compromise, and chronic inflammation leading to neurological deficits. Clinical manifestations include motor dysfunction, sensory impairment, and myelopathic reflexes. Diagnosis relies on imaging modalities such as MRI, CT, and X-ray. Surgical intervention is the primary treatment for moderate to severe Cervical Spondylotic Myelopathy (CSM) when conservative management fails. The optimal surgical approach for decompression surgery remains debated between anterior or posterior approach. A thorough understanding of the indications for each procedure significantly influences patient outcomes The main goals are to slow progression and restore function, with surgical approaches chosen based on pathology location for optimal decompression. Surgical outcomes show significant symptom relief, with prognosis influenced by disease severity and intervention timing.