Disorders of the cervical spine can lead to compression of neural elements and cause myelopathy, radiculopathy, or a combination of these conditions. Spinal cord or nerve root compression can be caused by a soft herniated nucleus pulposus, osteophyte formation, facet joint hypertrophy, and/or congenital abnormalities of the cervical spine. If nonoperative treatment fails, surgical treatment can often lead to excellent long-term clinical outcomes. The surgical treatment of these disorders depends on patient preference, clinical findings, and the evidence-based literature. In the properly selected patient, posterior cervical decompression for the treatment of radiculopathy provides potential advantages, including preservation of neck motion, avoidance of complications from anterior surgery, and fewer postoperative restrictions.