الفهرس 
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Abstract
Cervical spondylosis is a degenerative, age-related condition affecting both the anterior structures (intervertebral discs, uncovertebral joints and longitudinal ligaments) and the posterior structures (facet joints and ligamentum flavum) of the column leading to spinal canal stenosis. Risk of spondylosis of the cervical spine may be aggravated by some occupations and postures that increase the load of the head on the neck. The degenerative changes are the most common causes of clinical manifestations of spinal cord compression, which is called spondylotie myelopathy. These symptoms include; motor deficits of extremities, sensory deficits, reflexes, sphincter disturbance and gait disturbance. Most of these degenerative changes (about 85%) are diagnosed radiologically with plain radiographs, magnetic resonance imaging (MRI), and in some cases via electrodiagnosis
Prior to choosing a treatment strategy for the patients, it is important to objectively quantify functional impairment, quality of life and disease severity. The modified Japanese Orthopedic Association (mJOA) score is an investigator- administered tool used to evaluate neurological function in patients with DCM. It is an 18-point scale that addresses upper (5 points) and lower extremity (7 points) motor function, sensation (3 points) and micturition (3 points).
Treatment of cervical spondylosis is a matter of controversy. Many studies have shown improvement in the neurological status of severe myelopathy after surgical treatment, while did not have the same opinion about dissimilar cases of severity of symptoms that may improve with conservative management. Nevertheless, surgically; no agreement exists regarding the best approach for decompression. But as a golden rule anterior pathology should be addressed anteriorly while post pathology should be addressed posteriorly.
The aim of this study was to evaluate and compare the outcome of anterior and posterior decompressive approaches in treatment of spondylotic cervical myelopathy,
A prospective randomized comparative study was conducted on 66 Cases with degenerative cervical myelopathy who had surgical decompression either anterior or posterior approach in Neurosurgery department. Helwan University and Dar Elsafwa Hospital after An informed consent was obtained from the patients.
The main results of the study revealed that:
There is no significant difference between the studied groups as regard low pre and postoperative mJOA. However, there is a significant increase in mJOA from preoperative to postoperative in each of the studied subgroups.
There is no significant difference between the studied groups as regard pre and postoperative Nurick score. However, there is a significant decrease in Nurick score from preoperative to postoperative in each of the studied subgroups There is no significant difference between the studied groups regarding sex, and BMI but there was significant difference regarding the age of the patients.
There is no significant difference between the studied groups regarding comorbidities.
There is no significant difference between the studied groups regarding motor system affection.
There is no significant difference between the studied groups regarding sensory system affection.
Based on our results we recommend for further studies on larger patients and longer period of follow up to emphasize our conclusion.