The surgical management of cervical spondylotic radiculopathy and myelopathy.

Anterior fusion, laminectomy, and laminaplasty are recommended for the following conditions. For the treatment of one- or two-level spondylotic radiculopathy, anterior discectomy and fusion are preferred. For the treatment of spondylotic radiculopathy involving three or more levels, the open-door laminaplasty may be considered an alternative to anterior fusion. In this situation, laminaplasty is preferred for patients with developmental cervical canal stenosis, failed anterior fusion, or various prior anterior neck operations. Cervical laminectomy is indicated for patients with anterior bony ankylosis secondary to degenerative or inflammatory disorders and for patients in whom anterior fusion may be technically difficult, i.e., at C1-C3 or C7-T1. Anterior fusion is advisable for patients who have a structural reversal of the normal lordotic curve.