Table 2 Surgical procedures for cervical spondylotic myelopathy

Discectomy [28]

Radiculopathy; Myelopathy; Myelo-radiculopathy; Traumatic instability involving single or multiple levels

Increased age

Posterior cord/canal pathology

Recurrent laryngeal nerve injury -0.07 to 24.2%; Dysphagia – 12.3%; Hoarseness – 4.9%; unilateral vocal cord impairment -1.4%; Neurological complications – 0.3%; Pseudoarthrosis -6.9%*

Laminectomy with fusion [29]

Multi-level (> 3 segments), myelopathy

Cervical kyphosis

Cervical kyphosis -21%; Hypermobility; Spinal cord injury -3%; Nerve root injury -15%; Penetration of vertebral artery -5.8–6.7%

Circumferential decompression with fusion [30]

Bicolumnar failure; Flexion-compression injury; Burst fracture; Poor bone quality; More stable construct; decreases use of halo; improved graft fusion

Increased age

Vertebral fracture and graft extrusion; Fixed plate failure warranting revision surgery – 13%; Posterior wound failure – 3%

Laminoplasty [32, 42]

Multilevel spondylosis and OPLL

Cervical kyphosis

Poor results with 1–2 level decompression

Loss of lordosis – 22–53%; Kyphosis – 2–4%; Loss of ROM; decrease 17–50% and >70% with fusion; Infection; Fracture of the "hinged" side can lead to spinal cord injury; Axial neck pain -6–60%; Nerve root palsy 1–3 days post-op, predominantly motor loss of C5 – 11% (6.8% at 2 year follow-up)

Corpectomy [31]

Multi-level disease; Extends behind posterior vertebral body; Severe osteophytosis; VB deformity

Increased age

Posterior canal/cord pathology

Recurrent laryngeal nerve injury; CSF leakage; Sympathetic ganglion injury; Perforation of esophagus – 0.25%; Dysphagia – 45%; Veterbal artery injury – 0.3%; Bone graft complication; pseudoarthrosis – 7% with single level fusion and 30% with 3 level fusion