The following tests are required to confirm the diagnosis of spinal cord cavitation X-rays may reveal malformations in the foramen magnum area and Charcot joints. MRI is the best way to diagnose cavernous spinal cord because it clearly shows the extent, location, morphology, size and other deformities of the cavity. MRI of the brain and the entire spinal cord should be performed in all cases to examine the full extent of the cavity, assess the structure of the posterior cranial fossa, and determine the presence of hydrocephalus. If no Chiari malformation is found, an MRI contrast-enhanced scan should also be performed to look for the possibility of associated abnormal enhancement of the spinal cord tumor. In cases of tumors, astrocytomas or ventricular meningiomas in the gray matter of the spinal cord secrete proteinaceous fluid that accumulates above and below the tumor, widening the diameter of the spinal cord, causing lateralization of the posterior spinal column and neurological symptoms that can resemble spinal cavernous disease. The tumor is sometimes difficult to differentiate, especially if it is located in the lower cervical medulla. However, tumor cases have a fast progressive course and are more likely to occur in children and adolescents, where radicular pain is common and nutritional disorders are rare. In late stage, there may be an increase in cranial pressure and an increase in protein in the cerebrospinal fluid in early stage can be distinguished from this disease. MRI can be distinguished in difficult cases. 2, cervical spine osteoarthropathy Although cervical spine osteoarthropathy can have upper limb muscle atrophy and segmental sensory disorders, but no superficial sensory separation, radicular pain is common, muscle atrophy is often mild, generally no nutritional disorders, lesion level obvious segmental sensory disorders are rare. Cervical spine radiographs, myelography if necessary, and cervical spine CT or MRI can help confirm the diagnosis. Cervical ribs can cause limited atrophy of the small muscles of the hand and sensory deficits with or without evidence of subclavian artery compression, and because cervical ribs are often present in spinal cavernous disease, diagnostic confusion can occur. However, sensory deficits caused by the cervical ribs are usually limited to the ulnar aspect of the hand and forearm, and tactile deficits are more severe than pain deficits. The upper arm tendon reflexes are not affected and there are no cone fasciculation signs, which should make the distinction. Cervical spine radiographs are also helpful in establishing the diagnosis. 4. Syphilis Syphilis can be suspected of spinal cord cavitation in two ways. In rare proliferative dural spondylitis, upper extremity sensory deficits, atrophy, and weakness and lower extremity cone fasciculation signs can be seen, but myelography can show subarachnoid obstruction and the disease progresses more rapidly than spinal cord cavitation. Syphilitic tumors of the spinal cord may show signs of intramedullary tumors, although the progressive destruction of the disease is more rapid, and the disease is seropositive for syphilis. Diagnosis is based on slow progression, unilateral or bilateral segmental dissociative sensory deficits, unilateral upper extremity or hand muscle atrophy, neurotrophic deficits, and other congenital defects, combined with MRI findings.