Some people ask if they need surgery because of neck discomfort, while others refuse surgery out of fear when they are told they need it after examination. So what kind of patients need surgery? Here we introduce some basic knowledge of cervical spondylosis. Generally speaking, there are five types of cervical spondylosis: spinal, radicular, sympathetic, vertebral artery, and mixed, which means there are actually only four types, with the last one being a mixture of the others. Most types of cervical spondylosis can be relieved by conservative treatment, and even some cervical spondylosis can be cured by proper conservative treatment and healthy living habits, such as some sympathetic cervical spondylosis and vertebral artery cervical spondylosis, which can be completely cured by physical treatment of the neck (especially Chinese massage) and proper physical exercise (such as swimming, running, playing badminton, etc.) (but bad habits, such as long-term desk work, computer workers, long-term cell phone playing, etc., can lead to reappearance of the problem). Only severe spinal cervical spondylosis, which compresses the spinal cord or nerve roots and causes more serious symptoms of nerve or spinal cord injury, such as weakness of the limbs, numbness of the hands and feet, unstable walking, a feeling of stepping on cotton when walking, or numbness of the upper limbs due to compression of the nerve roots, which affects work and life, is considered for surgical treatment. Here are two cases of surgery to share with you. Case 1: A male patient, 31 years old, a computer technician, suffered from long-term chronic strain leading to multiple cervical disc degeneration, multi-segment cervical disc herniation, compression of the spinal cord and nerve roots, and spinal cord hemisection syndrome – sensory numbness on the left side and reduced muscle strength on the right side: sensory numbness in the left upper and lower extremities, normal muscle strength, and reduced muscle strength in the right upper and lower extremities. The left upper and lower extremities had numbness and normal muscle strength, while the right upper and lower extremities had weak muscle strength and swaying instability. Cervical spine X-ray examination showed that the cervical 5/6 intervertebral space was significantly narrowed, and cervical MRI examination showed cervical 3/4 – cervical 5/6 disc protrusion, cervical 4/5 and cervical 7/thoracic 1 disc prolapse, and spinal cord signal change, which was considered as spinal cord edema, and cervical spine enhanced MRI examination was performed, and neurological surgery consultation was requested to exclude tumor diseases and neurological diseases. After the surgery, the numbness on the left side was significantly relieved, the muscle strength on the right side was partially restored, and the feeling of thoracic girdle basically disappeared. Case 2: The patient was a 54-year-old female with a non-fracture dislocation type of cervical spinal cord injury caused by a traumatic injury, with incomplete paralysis of the limbs, muscle strength of the limbs at level 2-3, skin hypersensitivity of both upper limbs, and cervical spine MRI showing cervical medullary edema. In order to make the spinal cord injury return as soon as possible, the patient was advised to undergo surgery, but the patient refused surgery. After conservative treatment, the patient’s symptoms were relieved, but rather slowly. The patient was admitted to the hospital with the following findings: Post-injury MRI showing disc degeneration Post-injury MRI showing spinal cord edema Post-injury X-ray