Natural History of Cervical Spondylotic Myelopathy

Cervical spondylotic myelopathy (CSM) is a serious degenerative spinal condition that can lead to significant functional disability or paralysis. In cases of progressive neurological deficit from CSM, the recommended treatment is surgical decompression, sometimes including stabilization. The potential role of surgery or other treatments in milder cases of CSM depends upon many factors, including the natural history of the untreated condition. This chapter will examine the available data on the natural history of cervical spondylotic myelopathy, as well as its pathophysiology. Such knowledge will enable the clinician and surgeon to better guide the patient in deciding most appropriate choice of treatment options.