The choice of cervical spondylotic myelopathy treatment and prognostic factors are controversial.
Operative versus nonoperative management for patients with mild CSM, optimal surgical approaches for CSM, the utility of intraoperative monitoring, and radiographical prognostic indicators for outcome following surgery for CSM.
A current review reveals several areas where Class I evidence exists regarding these controversies. However, many other studies consist contain Class III or weaker data, thereby making it difficult to draw any definitive conclusions. Despite the lack of a consensus in some areas, it appears that CSM patients can often achieve satisfactory treatment through a variety of different options.
CSM remains a challenging clinical problem where several areas of controversy still exist. Large, multi-center, randomized prospective trials will be required to help resolve some of the controversies 1).