When dealing with degenerative disease at the cervical spine, the target of any procedure must be the complete removal of the cause of the damage to the myeloradicu-lar structures. When the pathological process causes an anterior compression, the anterior approach should be preferred. The release of the compressed neural structures via an anterior approach can be performed by several techniques, depending on the skill and experience of the surgeon in using a specific procedure (e.g., Cloward vs. Smith—Robinson vs. multilevel surgery).
In some patients, the stenosis is due to specific posterior abnormalities such as hypertrophy of the liga-mentum flavum, anomalies of the laminae and pedicles, and degenerative changes at the facet joints. Moreover, the spinal canal can be narrowed in a uniform manner on a congenital basis, or be segmentally stenotic for an ossification of the posterior longitudinal ligament (OPLL) disease. All these diseases can benefit from a surgical decompression from the back.
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Denaro, V., Denaro, L., Martino, A.D., Longo, U.G., Maffulli, N. (2010). Degenerative Disk Disease. In: Denaro, L., D'Avella, D., Denaro, V. (eds) Pitfalls in Cervical Spine Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-85019-9_10
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