Degenerative cervical spondylosis is closely related to age, and lifestyle, genetic factors, posture, exercise and work-related activities also influence the course of the disease. In many people, the age of the cervical spine does not correspond to their actual age (Figure 1). In short, the aging of the spine is complex and diverse. Figure 1 shows the cervical spine of a 46-year-old man on the left and MRI of an 80-year-old man on the right, showing the opposite of age. In the past, there was no evidence of the age of the cervical spine in the literature, so a study conducted by scholars at the Army Medical Center in Rome, Italy, proposed scoring criteria for the age of the cervical spine, and the article was recently published in EurSpineJ. How to determine the age of the cervical spine? The study analyzed the MRI of 423 cervical spine patients admitted to the center from January 2010 to July 2011, and the 6 evaluation indexes were as follows (C2 to C7, 6 segments, total score 25 to 98): 1. Disc degeneration (6 to 30 points): 1 point for normal disc, 2 points for dehydrated disc, 3 points for black disc, 4 points for herniated disc or vertebral body bones, 5 points for vertebral body bones bridge; 2. Yellow ligament degeneration (6 to 18 points): 1 point for normal, 2 points for hyperplastic ossification, 3 points for vertebral canal compression cut; 3. Vertebral body degeneration (6 to 18 points): 1 point for normal density, 2 points for signal change, 3 points for Modic change; 4. Cervical spine sequence (6 to 12 points): 1 point for normal, 2 points for abnormal; 5. Intervertebral foramen (0 to 12 points): 0 points for normal, 1 point for stenosis; 6. Spinal canal diameter in the narrowest plane ( 1 to 8 points): 1 point for normal, 2 points for less than 25%, 3 points for 25% to 50%, 4 points for 50% to 75%, 5 points for more than 75%, 6 points for high signal in one segment of the spinal cord, 7 points for high signal in multiple segments, and 8 points for spinal cord atrophy. Each index was scored and the scores of each index were summed to determine the age of the cervical spine. The results of the study showed that the data obtained from the scoring of these 426 patients were statistically analyzed and showed that these indicators were reliable. The imaging of the spine does not always correspond to the clinical presentation. The combination with the clinical outcome suggested that 424 cases rated cervical age under 50 years had no prosthetic fusion and no decrease in mobility 2 years after artificial disc replacement; 2 cases rated cervical age over 50 years had early prosthetic fusion, although the actual age was less than 50 years. Current treatments for degenerative cervical spondylosis are varied, with varying efficacy, and depend largely on the anatomical condition of the cervical spine. This study provides criteria for assessing this anatomical condition, i.e., cervical spine age, and helps in clinical decision making in the selection of treatment for degenerative cervical spondylosis.