Cervical spondylotic myelopathy

Cervical spondylotic myelopathy (CSM) is a degenerative condition secondary to cervical cord compression; symptoms are variable (clumsiness or a loss of fine motion skills in the hand, spastic gait, vesicoureteral disturbance) and are related to spinal canal narrowing and spinal cord compression due to intervertebral disk bulging, posterior bony spur, deformity of uncovertebral joints, and hypertrophy of facet joints and the ligamentum flavum. The therapeutic strategy should be decided on the basis of the symptoms, severity of cervical myelopathy, and general conditions. Surgery is not superior to conservative treatment for mild and moderate forms of CSM, whereas surgery is more suitable for patients with a clinically worse status.