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Professor Vincenzo Denaro has been an active member of the Institute of Clinical Orthopedics and Traumatology of the University of Catania since 1986. It has been my pleasure, as Director, to be associated with Professor Denaro, first as a Sessional Consultant in diseases of the spine and finally, after his promotion to the permanent staff, as Associate Professor. Professor Denaro began his postgraduate program of spe cialization, and hence his career, in the Orthopedic Clinic of the University of Pavia under the tutorship of Professor Mario Boni. It was the latter who directed and guided his develop ment in studying the disease processes of the vertebral column. In his pursuit of knowledge, he undertook additional studies in foreign clinics, including the Wellesley Hospital at the Uni versity of Toronto with Professor 1. MacNab and Professor V. F ornasier. He spent a full year at the Orthopedic Clinic of the University of Paris under the guidance of Professor Roy Camille. He derived great benefit from the clinical experience gained there and became acquainted with advanced and spe cialized surgical techniques specific to his field of interest. More recently, since accepting his current appointment, he has been able to put into practice the expertise developed over 20 years of study and research. Not only does he have extensive personal clinical experience, but he very wisely undertook to maintain a thorough, complete, and accurate record of the experience gathered from his case load.

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1 Introduction.- Definition.- References.- 2 Classification of Stenoses.- Functional Stenoses.- Organic Stenoses.- Congenital Stenoses.- Acquired Stenoses.- Combined Stenoses and Pathogenesis.- References.- 3 Anatomy and Anatomical Pathology.- The Cervical Vertebral Canal.- The Superior Cervical Unit.- The Inferior Cervical Unit.- The Nerve Root Canal.- The Vascular Supply of the Cervical Spine.- Dynamic Changes in the Cervical Vertebral Canal.- Pathological Anatomy.- 4 Biomechanics of Spondylotic Cervical Myelopathy.- Biomechanics of the Spinal Cord and Canal.- A Qualitatitve Biomechanical Analysis of Stresses in the Spinal Cord.- Discussion.- References.- 5 Imaging.- Traditional or Plain Radiography.- Computed Tomography.- Magnetic Resonance Imaging.- Myelography.- Arteriography.- Scintigraphy.- Conclusions.- References.- 6 Clinical Aspects of Cervical Stenosis.- Clinical Presentations.- Clinical Features.- Differential Diagnosis.- 7 Neurophysiological Studies in Cervical Stenosis.- EMG and NCV Findings.- Traditional EMG.- Reflex Response Studies.- Motor Conduction Studies.- Guidelines for Diagnosis.- Somatosensory Evoked Potentials.- Principles of Analysis.- Preoperative Assessment.- Intraoperative Monitoring.- Motor Evoked Potentials.- Conclusion.- References.- 8 Surgical Approaches.- Anterior Approaches.- Transoral Approach.- Mandible, Tongue, and Pharynx Splitting Approach.- Submandibular Approach.- Anterolateral Approaches.- High Presternocleidomastoid Approach (Retropharyngeal and Precarotid).- Low Presternocleidomastoid Approach (Retropharyngeal and Precarotid).- Presternocleidomastoid Approach (Retropharyngeal and Retrocarotid).- Retrosternocleidomastoid Approach.- Posterior Approach.- Combined Approaches.- Combined Unilateral Anterior Approaches.- Combined Bilateral Anterior Approaches.- Simultaneous Combined Anterior and Posterior Approaches.- References.- 9 Surgical Techniques.- Anterior Decompression.- Anterior Decompression Using Modified Cloward Instrumentation.- Transdiskal Anterior Decompression With Fusion.- Transdiskal Anterior Decompression Without Fusion.- Anterior Decompression with Multiple Subtotal Corpectomies.- Multiple Subtotal Corpectomies Without Massive Graft.- Anterior Decompression in Posttraumatic, Neoplastic, and Infectious Causes of Stenosis.- Anterolateral and Anteromedial Combined Approaches in the Surgical.- Management of Cervical Osteoarthritis P. H. Kehr.- and Pathogenesis.- Clinical Studies and Imaging.- Surgical Management.- Results and Conclusions.- Posterior Decompression V. Denaro.- Hemilaminectomy.- Laminectomy.- Techniques of Posterior Cervical Stabilization.- Expansive Open-Door Laminoplasty H. Hirabayashi and K. Satomi.- Bone Grafts V. Denaro.- Choice of Donor Site.- References.- 10 Causes of Poor Results.- Errors in Diagnosis.- Incorrect Level of Surgery.- Indications.- Incomplete or Inadequate Surgery.- Inadequate Postoperative Immobilization.- 11 Conclusion.

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