In order to better treat spinal cervical spondylosis, it is important to understand its natural course. The literature reports that the natural progression of spinal cervical spondylosis does follow a slow, steady, and gradual course in some patients, and there are even patients who seem to stop progressing after the initial onset of symptoms, and sometimes sensory and sphincter function also improves over time, but motor function and gait abnormalities usually persist or worsen, and the disease continues to worsen in 1/3-2/3 of patients, and there is never a disease cases of self-healing. Attempts have been made to find parameters that predict disease prognosis, but no one has found which clinical parameters, such as age, disease duration (acute or subacute), or lesion segment, can predict disease progression with certainty, but it seems that surgery in the elderly is less effective than in younger patients, and complication rates are higher. Current studies of imaging parameters have found that patients with normal preoperative cervical anterior convexity have better surgical outcomes, and high signal changes in the spinal cord on MRIT2-weighted images predict that spinal cord damage is irreversible and that patients are unlikely to achieve full neurological recovery with treatment. However, it has been reported in the literature that only multisegmental spinal cord signal changes on T2-weighted images can predict poor prognosis in spinal cervical spondylosis, and it has also been found that only high signal on well-defined T2-weighted images has such predictive value. Some scholars believe that T1-weighted images of spinal cord signal changes have more predictive value, and they found through autopsy that when there is a bottom signal in the spinal cord on T1-weighted images and a high signal on T2-weighted images at the same time, there is gray matter necrosis, spinal cord softening, and spongiosis in the spinal cord, while when there is a high signal on T2-weighted images alone, the pathological changes in the spinal cord are mild or only localized edema, so they believe that when T1-weighted images They therefore concluded that poor postoperative outcome can be predicted when low signal in the spinal cord is accompanied by high signal on T2-weighted images. Similarly, some scholars found that high signal in the spinal cord on T2-weighted images was reversible and postoperative signal improvement was associated with a good prognosis, whereas low signal on T1-weighted images was indeed irreversible and its presence signaled a poor prognosis.MRI diffusion-weighted imaging (DWI) may have a predictive role for whether the disease progresses, but further confirmation is needed. In addition, patients with normal preoperative median nerve somatosensory evoked potentials or abnormal wave amplitude but normal latency may have a better postoperative prognosis. Nevertheless, to date, there are no exact clinical or imaging parameters to predict disease progression.