Surgical treatment of myelopathy with cervical spondylosis.

The results of treatment over a period of 10 years of 102 cases of cervical spondylosis with myelopathy are presented, with a complete follow-up in all cases to two years after the end of that period. Results similar to those previously recorded were obtained with treatment by a light Minerva plaster collar, or laminectomy, but the best results, 73% sustained improvement, were obtained in 65 cases treated from an anterior approach, by Cloward's operation. Of 48 patients showing sustained improvement, 38 returned to, and remained at work. Cloward's operation was first undertaken at the beginning of the 10 year period, and was increasingly adopted as a primary procedure. It became evident that benefit from any treatment in cases with symptoms of long duration was likely to be limited, and the best results were in cases with less than a year's history who had Cloward's operation (86% sustained improvement). The necessity for careful clinical and radiological diagnosis, and operative technique, is emphasized, also the desirability of careful scrutiny of assessments in series of this disorder.