Cervical spondylosis is a degenerative disorder that is characterized by degeneration and secondary changes in the cervical discs, which compress or stimulate the adjacent nerves, spinal cord, blood vessels and esophagus and cause corresponding symptoms and signs. With the increase in the average life expectancy of our people and the rapid growth in the number of computer office workers, the number of patients with cervical spondylosis has also increased significantly. At the same time, due to the improvement of diagnostic imaging and in-depth research on the pathophysiological changes and pathological anatomy of cervical spondylosis, the surgical treatment of cervical spondylosis has become more scientific, individualized and standardized. Surgical treatment of cervical spondylosis requires strict mastery of surgical indications, perfection of surgical principles, and correct management of the occurrence of postoperative complications. Since Smith Robinson and Cloward et al. carried out anterior cervical surgery in the 1950s, the scope of surgical treatment for cervical spondylosis, surgical techniques, and surgical modalities have continued to develop, and the popularity of surgery has become increasingly widespread. However, not all cervical spondylosis is treated surgically, and most cervical spondylosis can actually be cured by conservative treatment. Therefore, surgical treatment has its indications. Under the premise of mastering the indications, surgery is performed in accordance with the principles of decompression, stabilization and restoration of physiological curvature, and the commonly used surgical approaches are anterior approach, posterior approach and combined anterior and posterior approach. The indications for surgery of cervical spondylosis and neurogenic cervical spondylosis have clear indications for surgery if the regular conservative treatment is ineffective for more than 3 months or if the conservative treatment is effective but the disease is recurrent and the clinical symptoms, signs and imaging (CT or MRI) are unified; the disease develops rapidly in 4-6 weeks after conservative treatment, especially the rapid deterioration of neurological function and dysfunction of the second stool. Surgery is needed in a timely manner. For vertebral artery cervical spondylosis with cervical instability and horizontal displacement of ≥3 mm or angular displacement of ≥11° or more, anterior fusion surgery is feasible if accompanied by symptoms of vertebrobasilar artery ischemia; anterior decompression surgery can be chosen if vertebral artery ischemia is caused by clear compression of the vertebral artery by osteophytes of the hook vertebral joint. The basic principles of surgical treatment of cervical spondylosis are decompression of the spinal cord and neural tissue, restoration of the physiological curvature and intervertebral height of the cervical spine, and stabilization of the diseased segment (bone graft fusion or fixation). 2.1 Decompression The pressure-causing factors of cervical spondylosis include the “soft” protruding intervertebral disc, hyperplastic yellow ligament and posterior longitudinal ligament, and the “hard” hyperplastic bony ligament and ossified ligament. Direct decompression is more desirable in terms of relieving pressure on the spinal cord and nerve roots, but indirect decompression is also possible if the compressor is extensive and cannot be decompressed directly. If the compressor is from a single segment of herniated disc tissue in the front, decompression is most direct through the anterior approach, but if the herniated disc is from multiple segments in the front and there is posterior ligamentous compression, indirect decompression through the posterior approach (single or double door surgery in the posterior cervical spine) can be chosen. Decompression must be thorough, thorough is not the same as extensive, while taking into account cervical spine stability. Restoring the normal sequence of the cervical spine to expand the volume of the spinal canal is also considered indirect decompression. 2.2 Implant fusion Although artificial cervical disc replacement after anterior decompression has been performed to preserve intervertebral mobility, the clinical observation period is short, the indications are narrow, and the long-term efficacy is inexact. Osseointegration as a guarantee of obtaining long-term stability of the cervical spine is still used as the standard procedure, and autologous three-sided cortical-iliac bone graft is the gold standard after anterior cervical osseointegration. In recent years several different types of artificial bone have been used in clinical practice. 2.3 Fixation In order to obtain immediate postoperative stability for early ground movement, internal fixation after decompression implantation is beneficial; internal fixation also helps to maintain the physiological curvature and intervertebral height of the cervical spine and prevent complications such as collapse and dislodgement of the implant block. Internal fixation in cervical spondylosis is divided into anterior fixation and posterior fixation. Anterior fixation system includes anterior plate, anterior cervical Cage and artificial intervertebral disc. The anterior plate should be pre-bent to accommodate the recovery of the physiological curvature of the cervical spine, and screws should be screwed in to avoid penetrating the endplate or screwing into the intervertebral space. When more than three plates are removed during posterior surgery or when the surviving vertebral segment is unstable, posterior internal fixation is required, and posterior internal fixation systems commonly include lateral block screw systems and pedicle nailing systems. 2.4 Restoration of cervical physiological curvature and intervertebral height The restoration of intervertebral space height and physiological curvature is the basis for maintaining normal cervical biomechanical properties. The same indirect decompression can be achieved. Intraoperative use of vertebral gap spacers is beneficial to the restoration of cervical physiological curvature and intervertebral height.