Neurogenic cervical spondylosis is a general term for the clinical manifestations of cervical spondylosis in which pain is mainly caused by nerve root compression due to degenerative disc changes and secondary pathological changes in the cervical spine. In its etiology, degenerative changes of the cervical disc are the most important cause in the development of cervical spondylosis. On this basis, a series of secondary pathological changes are caused, such as the formation of bone spurs on the posterior and lateral edges of the adjacent vertebrae, hyperplasia of the small joints and joints, thickening of the ligamentum flavum and the formation of folds in the spinal canal. The age of prevalence is 50 years old, with a male predominance, and the onset of the disease is mostly chronic. Symptoms may be unilateral or bilateral, usually involving a single nerve root, or may be caused by a multisegmental lesion resulting in compression of two or more nerve roots. Cervical spine lesions are mainly seen below cervical 4-5, with cervical 5, cervical 6 and cervical 7 nerve root involvement being the most common. Radicular pain is the most important clinical manifestation of neurogenic cervical spondylosis, and sometimes it is the only clinical manifestation. Since there is mostly single nerve root involvement, the pain is often limited to a specific area of the neck, chest or upper extremity. Rotation, lateral flexion or posterior extension of the cervical spine can induce or exacerbate radicular pain. The course of symptoms can be acute or chronic. Acute attacks tend to occur between 30 and 40 years of age, often a few days after neck trauma or with a history of previous neck trauma. The symptoms are mainly painful, manifested as severe neck pain and limited neck movement, neck pain radiates to the shoulder, arm, forearm and fingers, and there may be upper limb weakness and finger numbness. When the pain is severe, the patient may not even be able to sleep. The course of the disease is chronic, and most of the patients have developed from acute attacks, and a significant number of patients have multiple nerve root involvement. The age of the patient is higher than that of the patient with acute attack, which is characterized by dull pain in the neck and radiating pain in the upper extremities, and numbness in the scapula. Common triggers include lifting heavy objects. Based on the typical symptoms, signs and imaging, a preliminary diagnosis can usually be made. However, due to the need for diagnosis and treatment, especially surgical treatment, a localized diagnosis is required. The cervical 3 nerve root is susceptible to compression by the hyperplastic and hypertrophied cervical 3 hook and upper articular processes because the posterior root ganglion of the cervical 3 nerve root is close to the dural sac, whereas the herniated cervical 2 to 3 disc is less likely to compress the nerve root. The pain is severe and superficial, radiating from the neck to the auricle, eye and temporal region, and there may be burning and numbness on the affected side of the head, ear and jaw. Physical examination may sometimes reveal sensory disturbances behind the neck, around the ear, and in the jaw. There is no obvious muscle weakness. Cervical 4 nerve roots are common, with painful symptoms predominantly radiating from the back of the neck to the scapular and anterior thoracic regions, and the pain can be exacerbated by posterior extension of the cervical spine. The pain radiates from the posterior part of the neck to the scapular region and the anterior thoracic region. Cervical 5 nerve root The impaired sensory area is located in the shoulder and the lateral part of the upper arm, which is equivalent to the area where the shoulder cap is located. The complaints are mostly about shoulder pain, numbness, difficulty in lifting the upper limb, and difficulty in dressing, eating, and combing hair. Other muscles such as the infraspinatus, supraspinatus and part of the flexor elbow muscles may also be involved, but they are difficult to detect during physical examination. The biceps reflex may also be diminished. Cervical 6 nerve root is commonly involved, second only to cervical 7 nerve root involvement. Pain radiates from the neck along the biceps to the lateral forearm, the dorsal aspect of the hand (between the thumb and index finger), and the fingertips. Other muscles such as supraspinatus, infraspinatus, anterior serratus, posterior rotator, thumb extensors and radial wrist extensors may also be involved. The dysesthetic area is located in the lateral forearm and the “tiger’s mouth area” on the back of the hand. The cervical nerve root is the most common. Patients complain of pain radiating from the neck along the posterior shoulder and triceps muscle to the posterior lateral forearm and middle finger. The muscle strength of the triceps muscle can be reduced at an early stage, but often goes unnoticed, and is occasionally detected when the elbow is stretched. Sometimes the pectoralis major muscle is involved and atrophy occurs. Other muscles that may be involved include the pronator teres, wrist extensors, finger extensors, and latissimus dorsi. The area of sensory disturbance is located at the end of the middle finger. Cervical 8 nerve root Sensory impairment mainly occurs in the ulnar side of the ring finger and little finger, and patients complain of numbness in this area, but it rarely extends beyond the wrist. Pain symptoms are often not obvious, and physical examination may reveal hypotonia of the intrinsic muscles of the hand.