Cervical myelopathy associated with degenerative spine disease and ossification of the posterior longitudinal ligament.

Cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament are two of the leading etiologies of spinal cord damage in older patients. For most patients, the natural history is one of slow stepwise decline in function. With nonsurgical therapy only 30 to 50% of patients are expected to stabilize. Surgical options include anterior and posterior surgical decompression, spinal canal expansion, and spinal column stabilization. Prospective, randomized trials with standardized outcome measures are needed to clarify the benefit of surgery conclusively.