Thirty-four patients with spondylotic myelopathy underwent anterior cervical decompression and fusion with the Smith-Robinson technique. Followup was conducted at 6 months for all patients and at 18 months for 17 patients. No deteriorations occurred, and only 2 patients failed to improve. Progress reached a plateau after 4 months postoperative. Patients with vascular complaints were especially improved after surgery. Additional posterior decompression was required in 6 patients. No patient returned fully to normal. There are five indications for anterior surgery in myelopathy: vascular symptoms, instability, combined radiculopathy and myelopathy, minor spondylosis, and stress protrusion following anterior fusion.
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