48 males with a clear diagnosis of monomelic amyotrophy (MMA) were randomized to evaluate the efficacy of 2 surgical interventions in affected patients with an inability or unwillingness to wear a cervical collar. The 2 evaluated procedures were: anterior cervical discectomy decompression with autologous iliac crest bone grafting and internal plate fixation (DDF), and anterior cervical corpectomy and posterior longitudinal ligament resection with autologous iliac crest bone grafting and internal plate fixation (CDF). Patients were evaluated based on self-reported symptom assessments, and EMG outcomes. The evidence presented in this study demonstrated that the two surgical interventions are effective treatments for monomelic amyotrophy in males