Risks can occur in any surgery, and posterior open cervical spine surgery is no exception. It requires a rigorous pre-operative evaluation and is performed by a specialized surgeon, and although there are certain risks, they do not occur in every surgical patient. The main risks of posterior cervical open surgery include possible injury to the spinal nerves of the cervical spine, which may result in numbness of the limbs, walking dysfunction, or even paralysis, as well as urinary and fecal incontinence. There is also the possibility of injury to blood vessels during the operation, such as injury to the vertebral artery and vein, which may easily cause bleeding and postoperative epidural hematoma. Although there are certain risks, they do not occur in every surgical patient. The surgeon will inform the patient of the possible risks and precautions before the posterior open cervical spine surgery.