What is cervical lumbar syndrome? The 60-year-old master Chen 2 years ago gradually appeared numbness and weakness of the limbs pain, inflexible activities, walking unstable, legs can not open the symptoms, there are double lower limbs stepping on cotton feeling, chest waist like a belt strangulation feeling, after walking a distance, there is lumbago and one or bilateral lower limbs numbness, pain, weakness and other symptoms of intermittent limp. After the initial examination at the primary hospital, the doctor operated on Master Chen for lumbar spinal stenosis, and the symptoms of both lower limbs were slightly relieved after the surgery, but still not ideal. 1 year later, Master Chen came to the orthopedic department of North Medical College, and after a detailed examination by the doctor and a series of MRI and CT examinations, the doctor told Master Chen that he had cervicolumbar syndrome. That is to say, Master Chen’s cervical and lumbar spine spinal canal stenosis at the same time, appearing cervical segment spinal cord and lumbar nerve root compression at the same time, both spinal cord type cervical spondylosis and lumbar spinal stenosis, at the same time have two diseases, cervical spine also need to do surgery again. In clinical work, we found that 10% to 15% of patients with spinal cord cervical spondylosis can show symptoms of lumbar spinal stenosis, while some patients with lumbar spinal stenosis can also show symptoms of cervical spondylosis, and it is estimated that 5% to 10% of them can show symptoms of numbness and weakness of the limbs and inflexibility of spinal cord cervical spondylosis. Since cervical and lumbar syndrome is mainly caused by degeneration of the cervical and lumbar spine, the age of onset is mostly middle-aged and elderly. At present, the clinical naming of “cervical-lumbar syndrome” is confusing, but the real clinical differentiation and management significance is the simultaneous or sequential occurrence of spinal cord cervical spondylosis and lumbar spinal stenosis. The main clinical manifestations of cervicolumbar syndrome are the corresponding symptoms of spinal cord cervical spondylosis and lumbar spinal stenosis. Both may occur successively or coexist simultaneously, and the symptoms may be severe or mild, or both. In fact, cervical and lumbar syndrome is the superposition of the symptoms of spinal cord cervical spondylosis and lumbar spinal stenosis, covering each other. Since both spinal cord cervical spondylosis and lumbar spinal stenosis can present symptoms of the lower extremities, it is difficult for doctors to identify them in terms of clinical symptoms, signs and imaging manifestations, and cervical and lumbar spine degeneration and proliferation can be found in both cervical and lumbar spine on X-ray, such as narrowing of the intervertebral space, formation of bone redundancy, degenerative cervical spinal stenosis, cervical and lumbar instability, and lumbar spine slippage. CT and MRI can reveal the manifestations of cervical and lumbar spinal disc herniation, bone superfluous formation or hypertrophy of the ligamentum flavum into the spinal canal and compression of the cervical spinal cord and lumbar nerve roots. When Master Chen, mentioned earlier, was first seen in the primary hospital, the doctor ignored the cervical spine. In our clinical work, we found that among patients with long-term neck and shoulder pain or other various types of cervical spondylosis, there are many who also have chronic lumbar pain or lumbar leg pain; conversely, among patients with long-term chronic lumbar pain or lumbar leg pain, there are also many who also have neck and shoulder pain or other symptoms of cervical spondylosis. Why is this so? We know that the cervical and lumbar spine are the segments of the entire spine that are highly mobile and susceptible to strain and degeneration. Therefore, the cervical and lumbar spine have consistent changes in the degeneration of their intervertebral discs, and the intervertebral discs of the cervical and lumbar spine are prone to aging degeneration at the same time or successively when there are repeated strain and injury and other undesirable factors constantly acting on the cervical and lumbar spine. The common pathological basis of cervical spondylosis, lumbar disc herniation and lumbar spinal stenosis is degeneration of the intervertebral disc, followed by other degenerative changes in the cervical and lumbar spine, such as disc herniation, intervertebral space narrowing, bone spur formation, spinal stenosis and other manifestations, which are easily detected during X-ray examination in normal people over 40 years of age. When the degenerative manifestations of the cervical and lumbar spine mentioned above continue to develop to a certain extent, pain in the cervical and lumbar region can appear, and if it leads to irritation or compression of the spinal nerve roots, clinical symptoms such as numbness and weakness pain in the corresponding limbs will appear. Therefore, in this sense, the onset of cervical and lumbar disc degeneration association is neither accidental nor far-fetched; they are closely related in pathology and pathogenesis. Since cervical and lumbar syndrome is the same patient with two sites, treatment should take both into account and determine what should be the first, if the priorities are reversed, the efficacy will be affected. In general, surgery should be considered for cervical-lumbar syndrome, because the cervical spinal cord is compressed and affects a large area, and the symptoms caused by the lower limbs are much more extensive than those caused by the lumbar vertebrae, so when the symptoms caused by cervical-lumbar and leg pain are concurrent or difficult to distinguish, the principle of “cervical vertebrae first” should be grasped, and cervical spine surgery should be performed first, and after the symptoms caused by them disappear. If the symptoms caused by cervical and lumbar spine are different in severity, the site with the heavier symptoms should be selected for surgery first, and after a period of time, according to the degree of symptom relief and the change of symptoms in the other site, it should be decided whether to perform surgery on the other site again. It is generally believed that lumbar symptoms can be relieved after a longer period of rest after neck surgery; however, for those with heavy symptoms due to the lumbar spine and light symptoms due to the cervical spine, the changes in neck symptoms should be closely followed up after lumbar segment surgery, and once the symptoms due to the cervical spine are aggravated, surgery should be performed in a timely manner. Master Chen mentioned earlier, although the diagnosis is cervical-lumbar syndrome, but in fact the lesion of the cervical spine is heavy, and later received 1 cervical spine surgery before the symptoms improved significantly, and when he came to the hospital for a review 3 months after surgery, he walked freely, and even his partner said that he was like a new person after the cervical spine surgery. If Master Chen had gone to a hospital with a higher level of spine surgery when he first got sick, he might have been able to take fewer detours and might not have needed that one lumbar spine surgery.