Neurosurgical considerations of cervical myelopathy

Operative procedures on the cervical vertebral column and spinal cord must be selectively designed for the individual patient. Complete radiographic and neurophysiologic studies, including evaluation in various dynamic positions of the cervical spine (flexion, extension, and rotation), are necessary to define the most efficacious treatment method. No consensus exists regarding the exclusivity of a specific surgical procedure and all possible approaches should be considered, with the final decision based on detailed biomechanical considerations.