There are several types of cervical spondylosis, spinal cord type, cervical type, sympathetic type, and vertebral artery type. What is the definition of spinal cord cervical spondylosis? Spinal cord cervical spondylosis is caused by degeneration of the intervertebral joint structures of the cervical spine, such as disc herniation, bone spurs at the posterior edge of the vertebral body, hyperplasia of the hook vertebral joint, ossification of the posterior longitudinal ligament, hypertrophy or calcification of the ligamentum flavum, resulting in spinal cord compression or spinal cord ischemia, followed by spinal cord dysfunction, so spinal cord cervical spondylosis is one of the spinal cord compression disorders, which can be seriously disabling and accounts for 10% to 15% of all cervical spondylosis. What are the clinical manifestations of spinal cord cervical spondylosis? Spinal cord cervical spine lesion is one of the pathological changes of spinal cord compression. The clinical manifestations vary depending on the degree, location and extent of attack on the diseased spinal cord. Sensory disturbances are mostly irregular, numbness of the arm is common, but objectively superficial nociceptive disturbances do not necessarily correspond to the dermatomes innervated by the lesion, and deep sensation may be present in rare cases with thoracic or abdominal fasciculations, when they are often accompanied by enhanced abdominal wall reflexes. Hoffmann’s sign (Hoffmann’s sign) is mostly positive, and there may be a reverse radial reflex, i.e., tapping the brachioradialis muscle belly or biceps tendon to cause rapid flexion of the fingers, which is the same as the Hoffmann’s sign. Hoffmann’s sign is positive in the same sense, or appears earlier. A few high spinal cord lesions may show upper motor neuron damage such as increased muscle tone and hyperactive tendon reflexes. In the lower extremities, the upper motor neuron pathway is mostly abnormal, showing varying degrees of increased muscle tone and decreased muscle strength, active and hyperactive knee reflexes and Achilles tendon reflexes, positive ankle clonus, patellar clonus, and Babinski’s sign. Increased muscle tone and hyperactive tendon reflexes lead to unstable walking, especially fast walking, easy to fall, staggering gait, and spastic gait may occur. Spinal cord cervical spondylosis can cause difficulty in urination and defecation and sphincter dysfunction. What are the indications for surgery for spinal cord cervical spondylosis? If the disease progresses to the extent that symptoms such as unstable walking, walking on cotton, inability to hold things in the hand, or even muscle atrophy occur, the effect of conservative treatment is often unsatisfactory, and it is best to remove the nerve compression through surgery as soon as possible. This is because compression can cause damage to the spinal cord, which may lead to irreversible damage. If the presence of clear indications for surgery such as severe spinal cord compression is confirmed by symptoms, signs and imaging manifestations (X-rays, CT, MRI, etc.), surgical treatment is required. The primary goal of surgery is to relieve nerve compression, directly or indirectly expand the spinal canal volume, prevent further deterioration of spinal cord damage and improve nerve function. Do I need surgery immediately after diagnosis of spinal cord cervical spondylosis? The longer the compression lasts, the more severe the damage and the less effective the surgery will be. It is like when a person is crushed underneath after an earthquake, the sooner the person is rescued, the better, but if the person cannot be rescued after a long time, he or she will die. The same goes for the spinal cord. If the compression is paralyzed over time, it will be ineffective or ineffective if the compression is released. Therefore, once the diagnosis is confirmed, surgery is of course the sooner the better. What are the consequences if I don’t have surgery? Compression is a persistent and progressive problem. Nerves are very fragile tissues, and continued compression that is not released will eventually lead to damage to the nerve itself. If the spinal cord is compressed for too long or too severely, degeneration or cystic degeneration of the spinal cord may occur, which is called “high signal” changes in imaging. This level of nerve damage is usually irreparable and surgery is not likely to have a good outcome.