Does nonoperative management play a role in the treatment of cervical spondylotic myelopathy?

Abstract

Background context: Cervical spondylotic myelopathy has traditionally been managed through surgical decompression with or without reconstruction. Currently, a multicenter, blinded clinical trial that has supported such a therapeutic recommendation does not exist. There have been case-control studies that have and have not shown long-standing benefit to surgical decompression and reconstruction.

Purpose: The purpose of this review is to examine the efficacy of nonoperative therapy for cervical spondylotic myelopathy.

Conclusions: It appears that both static and dynamic factors play a role in the pathophysiology of cervical spondylotic myelopathy. Furthermore, once clinical cervical spondylotic myelopathy is evident, progression may occur despite the best of treatments, both surgical and nonsurgical.