Abstract: Background: Cervical spondylotic myelopathy (CSM) is considered the commonest cause of spinal cord dysfunction. Multiple levels are usually affected and about 20 – 60% of patients with CSM show progressive neurological deficit. As a result, the treatment of CSM is usually surgical. The treatment of multilevel CSM is controversial. It can be managed through anterior and/or posterior approach. Anterior surgery for multilevel CSM is usually associated with a high rate of complications. The two posterior techniques usually used for multilevel CSM are laminoplasty and laminectomy with lateral mass fusion. Laminectomy with lateral mass fusion allows adequate decompression of the cord, provides immediate stabilization of the spine, corrects and maintains cervical lordosis and prevents further degeneration at fused levels. In addition, it avoids postoperative kyphosis associated with non- instrumented laminectomy and can be used in the presence of cervical kyphosis and axial neck pain, a condition in which laminoplasty is not indicated.