Cervical ischemia is a syndrome of insufficient cerebral blood supply due to a decrease in effective blood flow in the vertebrobasilar artery caused by cervical factors. Cervical ischemia should be divided into acute and chronic phases, the acute phase manifests postural vertigo, tinnitus, nausea, vomiting, syncope, arrhythmia and other acute symptoms. In the chronic phase, there may be haze, headache, head swelling, hearing loss, memory loss, visual impairment, facial numbness, dysarthria, lower limb muscle weakness, ataxia, etc. The diagnosis of the acute phase should be excluded from otoliths. Acute phase diagnosis should be except otolithosis. Pathogenesis: vertebral artery compression; cervical vertebrae and intervertebral disc degeneration to the cervical vertebrae height and length of the vertebral artery of the equilibrium of the relationship between the destruction; sympathetic nerve stimulation theory; neck inflammatory mediators of the influence. Manipulation: Let the patient sit comfortably in a chair (the height of the chair should be adjustable in order to facilitate the treatment), according to the history, physical examination, imaging and palpation, find the responsible vertebrae or intervertebral discs, and then manipulate the affected vertebrae to restore the skewed or stabilized bone joints for the treatment, and pay special attention to selecting the correct treatment plane and sliding along the direction of articular facet movement without causing the patient’s pain.