A review of the current management of cervical spondylotic myelopath

ervical spondylotic myelopathy (CSM) is the commonest cause of non-traumatic paresis or paralysis in the middle age-group and above. It is an insidious slowly progressive disease with variable presentations. The commonest mode of presentation are neck pain, loss of fine movement of the hands and unsteady gait. Cervical spine magnetic resonance imaging (MRI) is the investigative tool of choice and this demonstrate the state of the disc, cord and neural tissue compression and help in decision making as regards management plan. The mainstay of treatment is surgery. The choice and approach of surgery depends on clinical presentation and findings from imaging. Though there is a role for conservative treatment in well selected group of patients but surgical treatment takes into account, the aim of decompressing neural tissue (cord and or nerve root) with or without stabilizing the spine.