When to have surgery for cervical spondylosis At what point does cervical spondylosis usually progress to the point where we patients need to opt for surgery? To clarify this question, we need to know what cervical spondylosis is all about. Cervical spondylosis is a herniated disc, bone spur and vertebral bone loosening compression stimulates the nerves or blood vessels in the neck, so that the nerves are directly and indirectly damaged, if not treated exactly, these causes exist for a long time, the nerves will successively out of inflammatory edema, ischemic metabolic disorders, demyelination changes and cell necrosis, the patients themselves can notice is the limb pain, numbness, weakness, grasping walking difficulties, and even the emergence of an arm or quadriplegia. It is like a stone pressed against a seedling, some seedlings can adapt, others cannot, and will gradually turn yellow and eventually die. Removing the stone to free the seedling is the same as surgical decompression to liberate the nerve, which requires timing and decisiveness. The timing of surgery is not quite the same for different types of cervical spondylosis. For cervical spondylosis of the nerve root type, we first still recommend the patient to brake the neck brace, take adequate rest, take oral medication and do physical therapy, but there are some cases to consider surgery. The first is that the pain and numbness in the neck, shoulder or arm is very intense, some even to the fingers, and sleeplessness at night, which seriously affects life. When the pain is not relieved by some analgesic drugs, surgery is required at this time. Especially from the cervical spine MRI, the nerve compression is very serious, if not timely surgery, may be nerve necrosis. Some patients start with severe pain and suddenly one night the pain is gone, but there is no strength in the hands and the muscles are paralyzed. Generally, the symptoms of nerve injury vary from mild to severe patients, starting with pain and sensory hypersensitivity, then heavy is numbness and weakness, and then severe is no pain, is muscle paralysis and muscle atrophy. According to this analysis, so we can not wait until the muscle paralysis until it becomes very numb before doing surgery. The second situation is that the cervical spondylosis is very painful and affects life, and it is not relieved by one month or even two or three months of treatment and observation, so surgery is also considered at this time. What is the effect of surgery? Any patient who is suitable for surgical treatment, the effect of surgical treatment is generally very good, but the effect of surgery, too, depends on the choice of the timing of treatment. Once there is a clear indication for surgery and there are no contraindications to surgery, it is advisable to operate as early as possible. Why? Because early surgery has good results. The traditional concept of Chinese people is that it is not easy to accept or receive surgical treatment immediately. In fact, this bear and carry may not only endure the pain for nothing, but also may delay the control of the disease, affect the effect of surgery, and even have serious consequences. Unlike neurogenic cervical spondylosis, most spinal cord cervical spondylosis requires surgery and conservative treatment is ineffective. This type of patient mainly suffers from weakness and numbness of the limbs, inflexibility and clumsiness of the hands, unstable walking with the feeling of stepping on cotton, etc. It is a serious type of cervical spondylosis, and if it is not treated, most patients (60-80%) will have their condition aggravated and the final result is paralysis. Therefore, this type of cervical spondylosis should be treated surgically as soon as it is diagnosed, and the lighter the condition, the earlier the surgery, the better the result. If the nerve is already necrotic, even surgery cannot save it. Sympathetic cervical spondylosis (vertebral artery type cervical spondylosis is rare, and most of the diagnosed vertebral artery type is actually sympathetic type) is mainly characterized by symptoms such as dizziness and headache, panic and chest tightness, nausea and vomiting, eye pain and eye distension and blurred vision, and unstable high and low blood pressure. Although most people advocate conservative treatment, in clinical practice we find that conservative treatment of sympathetic cervical spondylosis is often ineffective and the disease is very easy to recur. These patients have a variety of subjective symptoms and are very easy to be misdiagnosed, and most of them wander to neurology, cardiovascular medicine, gastroenterology and otorhinolaryngology, and are not properly diagnosed and treated for a long time. These patients are also prone to recurrent symptoms and need to be treated with great care and stamina. Patients with severe symptoms of recurrent painful abnormal episodes can be treated with conventional surgery or, in lighter cases, with minimally invasive low-temperature plasma interventions, most of which can be effective. The main goal of surgical treatment is to eliminate the intervertebral discs or bone spurs that are causing nerve compression, to re-stabilize the loosened cervical spine, and to improve blood circulation to the nerves. Regardless of whether it is the nerve root or the spinal cord that is being compressed, the ultimate goal is to remove these diseased tissue structures so that the nerve is well relieved and liberated. There are many ways to do this, either by going in from the front and cutting out the disc, or by going to the back and opening up the spinal canal. Patients with cervical spondylosis who also have diabetes or hypertension can still have normal surgery if they are controlled by medication after admission to the hospital to meet the required index. However, there are some patients who are not suitable for surgery because they may suffer from some other serious diseases or have some other problems in themselves, which are called contraindications to surgery. For example, if the patient has a serious heart problem (such as acute heart attack), or has severe emphysema or asthma, this patient is usually not able to tolerate general anesthesia and cannot tolerate surgery. This is a major surgery for him, although we may do a single segment anterior cervical surgery in 30 minutes and 40 minutes, which is not very big, and there is not much bleeding, that is, about 10 ml to 20 ml of bleeding, but for these patients, when he has a serious underlying disease, we should be especially careful.