Cervical spondylosis. Part II: surgical management

The hypothesis is presented that the way to improve the results of surgery for cervical spondylosis is to be more critical and selective when deciding if surgery is appropriate and to tailor the operative technique to the needs of each individual patient. The process of choosing the operative route and technique is described and evaluated in relation to the results. Despite a large volume of published work the results are often equivocal and there is little to show that one method is better than another. The major development over the past decade has been the advent of a plethora of disc prostheses and plating systems. The evidence for the value of these is equivocal except for certain defined indications. The future promises even more exciting developments. It is to be hoped that the scientific evaluation of these will be more rigorous.