There is a type of cervical spondylosis that we call neurogenic cervical spondylosis, which is caused by degeneration of the cervical spine, compression of the spinal nerve roots or passive pulling to produce neurogenic symptoms. The symptoms are: nerve trunk pain or plexus pain consistent with the affected nerve, along with sensory disturbance, etc., reduced tone in the innervation area, and reduced or absent tendon reflexes. One of the manifestations is numbness in the upper extremities, which is also one of the manifestations. However, there are many other diseases that also show numbness in the upper extremities, so we need to differentiate them. Today, we will make a brief analysis of the differential diagnosis. Ulnar neuritis Similar to the symptoms of cervical 8 nerve root involvement in cervical spondylosis, both can present with ulnar side numbness of the hand and intrinsic muscle atrophy, but ulnar neuritis is mostly accompanied by osteoarthritic changes in the elbow joint, pressure pain in the ulnar nerve groove at the elbow, and a positive nerve percussion test (Tinel’s sign). In addition, the distribution of sensory disorders is also different between the two. The cervical 8 nerve root innervation area is larger, and there is more numbness in the ulnar side of the forearm, while there is no numbness in the forearm in ulnar neuritis. Carpal tunnel syndrome Numbness or pain in the fingers due to pressure on the median nerve passing through the carpal tunnel is distinguished by a positive carpal tunnel compression test or a positive wrist dorsiflexion test in carpal tunnel syndrome. Thoracic outlet syndrome is caused by compression of the brachial plexus nerve, subclavian artery and venous trunk at the thoracic outlet by the anterior oblique muscles, cervical ribs and other structures, resulting in numbness and pain in the upper limbs. The difference between the two is that the numbness in thoracic outlet syndrome often lacks radicular distribution characteristics and there is pressure pain at the attachment point of the anterior oblique muscle that radiates to the hand. In addition, the thoracic outlet syndrome has a positive oblique angle muscle test (Adson’s sign) and a positive upper extremity hyperextension test. x-ray examination sometimes reveals cervical 7 vertebral transverse process overgrowth and cervical ribs. Spinal cord cavitation This disease is characterized by the formation of tubular cavities and gliosis in the spinal cord. CT and MRI may be useful in differentiation. Diabetic peripheral neuropathy is a common microvascular complication of diabetes mellitus. The numbness is more common in the lower extremities, typically with glove-like sensory impairment in both lower extremities, and the symptoms are more severe in the lower extremities than in the upper extremities, and more severe in the distal extremities than in the proximal extremities, with peripheral neuropathy. Blood glucose monitoring, electromyography and cervical spine imaging can assist in differentiation. In addition, upper extremity numbness can also be seen in stroke. For middle-aged people over 40 years of age who frequently present with headache, vertigo, and numbness in the extremities, they should be alerted to the occurrence of stroke. As a major symptom of cervical spondylosis, upper limb numbness should be taken seriously by clinicians. It is relatively easy to confirm the diagnosis of cervical spondylosis, but there are similarities with the numbness symptoms manifested by related diseases caused by peripheral nerve entrapment, and the two diseases may coexist, thus requiring a clear diagnosis.