HE controversy regarding the management of cervical spondylotic myeloradiculopathy persists, with proponents vigorously supporting an increasing number of surgical procedures. 3,4,s,1~ The ideal operation ;hould relieve the spinal cord and nerve roots from pressures in all quadrants, including those exerted ventrally by osteophytes, 2,1~,25 and dorsally by infolded yellow ligaments, 35 lamina, 7,1~ or osteophytes on the posterior facets2 6 The anterior operative approach stresses a direct attack on the ventral osteophytes by traversing the vertebral body; however this approach does not allow treatment of problems related to the size of the spinal canal and the posterior elements 9,~,~~ in cases where laminectomy and foraminotomy are necessary2 ~ Recently, extensive unroofing of the entire cervical canal has been recommended in an effort to disengage the cord from the ventrally situated osteophytes ~,2,~,~ but this procedure does not solve the problem of nerve root entrapment caused by foraminal osteophytes. Circumferential decompression of the spinal cord and nerve roots can be achieved if the procedure of laminectomy and foraminotomy is augmented by the removal of ridges and spurs from the floor and foramina of the spinal canal; this can be accomplished with the use of sharp, downbiting straight and angulated curettes and rasps. The procedure thus makes extensive laminectomy unnecessary.2,~,z Early results in the treatment of cervical
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Epstein et al. (1969) studied this question.