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Surgical intervention is commonly required in the management of cervical spondylotic myelopathy to arrest the progression of myelopathic symptoms. 1 This can be achieved through an anterior, posterior, or circumferential decompression, with or without instrumented fusion. 1,2 Posterior cervical decompression and fusion (PCDF) is considered safe and efficacious, and can be performed with pedicle screws or lateral mass screws, with current controversy regarding the more efficacious mode of instrumentation. 3 The purpose of this article is to debate the advantages of each screw fixation technique.

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