Mainly neck and shoulder and arm pain, neck stiffness and limited movement. The neck and shoulder pain may radiate to the head and occipital region and upper limbs, and some are accompanied by dizziness, nausea and vomiting, vertigo, and sudden collapse. Some have fever on one side of the face and sometimes abnormal sweating. Weakness of hand grip and grip falling to the ground. Some patients have weakness in the lower limbs, unstable walking, numbness in the second foot, and a feeling like stepping on cotton when walking. When cervical spondylosis involves sympathetic nerves, dizziness, headache, blurred vision, eye discomfort, tinnitus, balance disorder, tachycardia, panic, tight c feeling in the chest, etc. may occur. A few people experience loss of control of bowel movements and urination, sexual dysfunction, and even tetraplegia. There are also symptoms such as dysphagia and dysphonia. These symptoms are related to the degree of onset and duration of onset. Physical examination shows paravertebral or spinous process pressure pain, restricted range of motion of the cervical spine, radicular pain or numbness on intervertebral foramen squeeze test, reduced pain and numbness in the upper limbs on intervertebral foramen separation test, numbness or radiating pain in the limbs on nerve root pull test (brachial plexus pull test), decreased muscle strength or increased muscle tone, and positive pathological signs such as Hoffman. Classification of cervical spondylosis 1, neurogenic type The incidence of cervical spondylosis accounts for 50%-70%, and the narrowing of the intervertebral foramen causes compression of the cervical spinal nerve, mostly in the 4-7 cervical spine. The early symptoms are neck pain and neck stiffness; radiating pain or numbness in the upper limbs, which radiates along the direction of the compressed nerve root and the area of innervation, and sometimes the appearance and relief of the symptoms are obviously related to the position and posture of the patient’s neck; the affected upper limbs feel heavy and have reduced grip strength, and sometimes there are falling objects. 2.Spinal cord type Causes spinal cord compression, inflammation, edema, etc. The main manifestations are: numbness and heaviness of the lower limbs, difficulty in walking, and the feeling of stepping on cotton in both feet; numbness and pain in the upper limbs, weakness and inflexibility in both hands, difficulty in completing fine movements, and the tendency to drop objects; abnormal sensation in the trunk, and patients often feel a belt-like binding sensation in the chest, abdomen, or both lower limbs. 3.Sympathetic nerve type The sympathetic nerve endings on the nerve roots, joint capsule or collateral ligament are provoked. Main manifestations: dizziness, headache, poor sleep, memory loss, difficulty concentrating; eye swelling, blurred vision; tinnitus, ear blockage, hearing loss; nasal congestion, “allergic rhinitis”, foreign body sensation in the throat, dry mouth, vocal cord fatigue; nausea or even vomiting, bloating, diarrhea, indigestion, belching, etc.; palpitations, chest tightness, heart rate changes The heart rate changes, arrhythmia, blood pressure changes, etc.; excessive sweating, no sweating, chills or fever on the face or a certain limb. 4.Vertebral artery type Insufficient blood supply due to bone spur, vascular variation or lesion. Main symptoms: episodes of vertigo, diplopia with nystagmus. Sometimes accompanied by nausea, vomiting, tinnitus or hearing loss. These symptoms are associated with a change in neck position; sudden weakness of the lower extremities with sudden collapse but consciousness, mostly occurring when the head and neck are in a certain position. Occasionally, there is numbness and abnormal sensation in the limbs. 5.Compound type The above two or more types exist at the same time. Special examination: the degree of spinal stenosis can be clarified by CT, and MRI can understand the spinal cord compression and guide the determination of treatment plan. Diagnosis The diagnosis of cervical spondylosis mainly relies on clinical manifestations and imaging examination, but when conditions permit, borrowing some auxiliary methods can be helpful in determining the nature and location of lesions and differential diagnosis, such as Quiggin’s test, myelography, vertebral arteriography, etc. Differential diagnosis Differentiation of neurogenic cervical spondylosis, manifested as brachial plexus neuralgia, should be differentiated from amyotrophic lateral sclerosis, anterior trapezius syndrome or “thoracic outlet syndrome”, supraclavicular mass or Pancoast tumor, shoulder pain and shoulder disorders, radiculitis, angina pectoris, rheumatism, etc. Spinal cord cervical spondylosis should be differentiated from spinal cord tumor, adhesive spinal cord arachnoiditis, spinal cord cavitation, and ossification of the posterior longitudinal ligament. Differentiation of vertebral artery type cervical spondylosis Among all types of cervical spondylosis, the vertebral artery type is quite common and its incidence is second only to the root type. The first, second and third segments of the vertebral artery can be twisted and compressed unilaterally or bilaterally, and spasm occurs under the influence of the cervical sympathetic nerve, causing different degrees of inadequate blood supply to the vertebral artery. There are many conditions that need to be differentiated: inner ear disorders, ophthalmogenic vertigo, arteriosclerosis, retrosternal goiter, other conditions such as vertigo and neurosis caused by anemia or after prolonged bed rest.