Anterior surgical approaches to treat degenerative cervical myelopathy

Cervical spondylotic myelopathy (CSM) is an acquired degenerative condition of insidious deterioration of neurologic function due to chronic compression of the cervical spinal cord. Patients commonly require a decompressive surgical procedure to relieve the pressure on the spinal cord and nerve roots, with goals of halting the progressive neurologic deficits and rehabilitating toward improvement. Cervical spine decompression can be achieved both anteriorly and posteriorly. This chapter focuses on anterior surgical approaches to the cervical spine for patients with CSM. Knowledge of pertinent surgical anatomy and surgical technique are key essentials to achieving adequate decompression while maintaining low operative morbidity. This chapter also draws comparisons to the multiple grafts and devices that are used during surgery for these patients.