Cervical Spondylotic Myelopathy: World Federation of Neurosurgical Societies (WFNS) to the Italian Neurosurgical Society (SINch) Recommendations

Cervical spondylotic myelopathy (CSM) is a progressively growing pathology to afford by a spinal surgeon due to the aging of the population, associated with better treatment manage-ment and the best diagnosis and treatment solutions are greatly discussed. Nowadays that scientific literature is progressively increasing to identify the gold standard in diagnosis and treatment can be very challenging. This is particularly evident in spinal surgery with many different indications not only in different countries but also in the same local reality. In this scenario, many neurosurgical societies works to identify some guideline or recommenda-tions to help spinal surgeons in daily practice. Furthermore, in an era in which legal issues are increasingly present in clinical practice to have some indications globally accepted can be very useful. World Federation of Neurosurgical Societies (WFNS) few years ago starts this process creating a list of recommendations originating from a worldwide steering com-mittee to respect all the local reality. The spinal section of Italian Neurosurgical Society de-cides to adopt the WFNS recommendations with some revision basing on Italian scenario. The steering committee of the Spinal Section of Italian Neurosurgical Society identify 7 groups to review the literature of the last 10 years about different topics on CSM and to analyses the WFNS recommendations to adapt it to the Italian daily practice. The state-ments were discussed and voted in 2 sessions to obtain the final version. A list of recom-mendations on natural course and clinical presentation; diagnostic tests; conservative and surgical treatment; anterior, posterior and combined surgical treatment; role of neurophys-iological monitoring and follow-up and outcome was created with only few new or revised statements respect the ones of WFNS. The Spine Section of Italian Neurosurgical Society create a list of recommendations that represent the more contemporary treatment concepts for CSM as presented in the highest quality clinical literature and best clinical practices available on this subject.

Automated summary

Cervical spondylotic myelopathy (CSM) is becoming more common due to the aging population, and finding the best diagnosis and treatment solutions is challenging. Many neurosurgical societies are working on guidelines to help spinal surgeons in their daily practice. The Italian Neurosurgical Society's Spinal Section adopted the recommendations of the World Federation of Neurosurgical Societies (WFNS) with some revisions based on the Italian context. They reviewed the literature and analyzed the WFNS recommendations to create a list of contemporary treatment concepts for CSM.