Fusion or no Fusion After Decompression of the Spinal Cord in Patients With Degenerative Cervical Myelopathy

Inclusion Criteria: * Age \>18 years * 1-4 levels of cervical degenerative myelopathy in the subaxial spine, C3-C7, without or with deformity not exceeding exclusion criteria, see below. * Eligible for both treatments * Ability to understand and read Swedish language * Symptomatic myelopathy with at least one clinical sign of myelopathy * No previous spine surgery * Psychosocially, mentally, and physically able to fully comply with this protocol, including adhering to scheduled visits, treatment plan, completing forms, and other study procedures * Personally, signed and dated informed consent document prior to any study-related procedures, indicating that the patient has been informed of all pertinent aspects of the trial * Definition of kyphosis - cSVA \> 40 mm and/or C2-C7 Cobb \> 10° kyphosis. Definition of spondylolisthesis - anterior slippage of \> 2 mm on cervical radiographs taken in the neutral position. Exclusion Criteria: * Local kyphosis; a modified K-line minimum interval distance (INT) of \<4 mm * Spondylolisthesis \>4 mm and simultaneous translation \>2 mm on lateral flexion/extension radiographs * Soft disc herniations only (no signs of osteophyte formation and hypertrophy of the ligamentum flavum) * Active infection * Neoplasm * Trauma * Inflammatory disease (i.e., rheumatoid arthritis or ankylosing spondylitis or DISH) * Systemic disease including HIV * Lumbar or thoracic spinal disease to the extent that surgical consideration is probable or anticipated within 6 months after the cervical surgical treatment (significant lumbar stenosis as defined by Schizas C or worse). * OPLL * Parkinson´s disease * Drug abuse, dementia, or other reason to suspect poor adherence to follow-up * Previous cervical spine surgery