Surgical Decision Making in Cervical Spondylotic Myelopathy: Comparison of Anterior and Posterior Approach

available in the literature, it is estimated that 1.6 of every 100,000 individuals are surgically treated for this condition.4 This statistic suggests that the number of individuals who experience CSM is much higher. Preferred initial treatment for CSM includes nonoperative modalities such as physical therapy; anti-inflammatory medications; and in some cases, a cervical collar. However, refractory cases may require surgical intervention. Current literature has demonstrated surgical decompression of the cervical spine to improve functional outcomes in patients with CSM.5,6 Decompression can be achieved via an anterior or a posterior approach; each method of decompression has its own advantages and disadvantages. To our knowledge, there are no published randomized controlled clinical studies that compare the two approaches directly, which prevents clear conclusions from being drawn. Therefore, this review aims to summarize the current literature regarding anterior and posterior approaches for the treatment of CSM, with specific emphasis on comparing treatment safety and efficacy.