Cervical spondylotic myelopathy (CSM) is the most common form of myelopathy affecting human spine. It’s a clinical condition associated with a significant compression of the spinal cord leading to a wide variety of clinical features, depending on the grade of disease and rapidity of development. The most common underlying cause is spondylitis of the spine(wear and tear). Spinal degeneration is usually affects the inter-vertebral disc, facet joints and the other connecting ligaments, with variable degrees of spinal canal narrowing and cord compression. In certain cases, idiopathic diffuse inflammation and calcification of the spinal ligaments, joints and other connective tissues, leading to spinal fusion and narrowing of the spinal canal, the condition is called DISH(diffuse idiopathic skeletal hyperostosis), when it’s mainly affecting posterior longitudinal ligament, the condition is called Ossification of posterior longitudinal ligament (OPLL).
If the condition is a symptomatic, conservative treatment and active monitoring is an option of management. The most common surgical options to decompress the spinal cord is either anterior approach, cervical discectomy and fusion, or posterior approach, cervical laminectomy -/+spinal fusion.