Abstract
Surgical techniques and technology for cervical spondylotic myelopathy (CSM) have demonstrated remarkable advancement during the past decade. This narrative review examines the evolution of surgical approaches and technological innovations, focusing on both anterior and posterior techniques. Anterior approaches have progressed through the development of endoscopic procedures, novel decompression methods such as vertebral body sliding osteotomy, and advanced implant materials including 3D-printed customized devices. Posterior approaches have evolved with the integration of endoscopic techniques and refined fixation methods, demonstrating reduced tissue trauma and improved outcomes. The integration of surgical assistance technologies, including navigation systems, robotics, and augmented reality, has enhanced surgical precision while potentially reducing procedural risks. While these advances show promising outcomes in terms of surgical precision and patient recovery, challenges persist regarding technology implementation and cost-effectiveness. Emerging technologies such as artificial intelligence for surgical planning, patient-specific implants, and adjunctive biological therapies may further improve CSM treatment. The optimal application of these innovations requires continued research and careful evaluation to establish their long-term efficacy and safety in clinical practice.