Posterior Cervical Decompression and Instrumented Fusion for Cervical Spondylotic Myelopathy: 2-Dimensional Operative...

Cervical spondylotic myelopathy is a common cause of progressive quadriparesis in adults. It is characterized by compression of the cervical spinal cord due to degenerative changes including intervertebral disc protrusion, ligamentum flavum hypertrophy, and osteophyte formation. Clinically, patients can present with declining motor control in the extremities, gait imbalance, spasticity, hyperreflexia, or possibly frank weakness. Surgical treatment options include ventral and dorsal approaches, whose indications vary depending on spinal alignment, number of levels requiring decompression, the dorsal/ventral/circumferential location of compression, and patient-specific anatomic constraints. Posterior cervical decompression and instrumented fusion is a mainstay of treatment for cervical spondylotic myelopathy when a dorsal approach is indicated. In this video, we present a case of a 60-yr-old female who presented with signs and symptoms of cervical myelopathy, with MRI findings of C3 on C4 anterolisthesis and circumferential central stenosis worst at C4-5 and C5-6. We demonstrate the operative steps to complete a C3 to C6 decompression and instrumented fusion with lateral mass screws. Appropriate patient consent was obtained.