Cervical spondylosis is a syndrome of a series of symptoms and signs resulting from changes in the cervical vertebrae such as osteophytes, calcification of the cervical collateral ligaments, and atrophy and degeneration of the cervical intervertebral discs, which stimulate or compress the cervical nerves, spinal cord, and blood vessels. Although there is no mention of cervical spondylosis in Chinese medicine, its related symptoms are scattered in the discussion of paralysis, impotence, collar strength, vertigo, etc. Diagnostic points 1. Neurogenic cervical spondylosis (1) Most patients gradually feel unilateral restricted pain in the neck, with electric shock-like radiation from the cervical root to the shoulder, upper arm, forearm and even the fingers, and a numbness, either mainly pain or mainly numbness. The pain is sore, burning or electric shock-like, and can be aggravated by posterior neck extension, coughing, or even increasing abdominal pressure. The upper extremities are heavy, sore and weak, and hold objects that fall easily. Some patients may have dizziness, tinnitus, ear pain, reduced grip strength and muscle atrophy, and the neck of such patients is often painless. (2) Restriction of neck movement, stiffness, radiating pressure pain on the anterior side of the cervical transverse process, and pressure pain points on the upper part of the scapula on the affected side, some patients may feel striated nodules, decreased sensation in the skin segment distribution area of the compressed nerve root, abnormal tendon reflexes, and decreased muscle strength. In cervical 5-6 intervertebral lesions, stimulation of the cervical 6 nerve root causes hyperalgesia of the affected thumb or thumb and index finger; in cervical 6-7 intervertebral lesions, stimulation of the cervical 7 nerve root causes hyperalgesia of the index and middle fingers. The brachial plexus nerve pull test is positive, and the cervical intervertebral foramen squeeze test is positive. (3) X-rays of the cervical spine in the frontal and lateral, oblique or lateral hyperextension and hyperflexion positions can show changes such as vertebral body hyperplasia, crooked vertebral joint hyperplasia, narrowing of the vertebral space, reduction, loss or anteversion of the physiological curvature of the cervical spine, mild slippage, calcification of the collateral ligament and small intervertebral foramen. 2, spinal cord type cervical spondylosis (1) slowly progressive numbness, coldness, pain in both lower limbs, walking with weakness, weakness, playing soft legs, easy to trip and unable to cross obstacles. The symptoms are relieved when resting, aggravated by stress and exertion, and gradually aggravated when slow and dramatic. In the late stage, lower limbs or quadriplegia, incontinence or urinary retention. (2) The restriction of neck movement is not obvious, the upper limbs are not flexible, the sensory and motor disorders of bilateral spinal cord conduction tracts, i.e. sensory disorders below the compressed spinal cord segments, increased muscle tone, hyperreflexia, and positive cone bundle signs. (3) X-ray radiographs show changes in the physiological curvature of the cervical spine, narrowing of the intervertebral space, lip-like bone redundancy at the posterior edge of the vertebral body, and small intervertebral foramina; CT examination shows degeneration of the cervical intervertebral disc, cervical spine hyperplasia, narrowing of the anterior and posterior diameters of the spinal canal, and changes in spinal cord compression; MRI examination shows signal changes in the spinal cord of the compressed segment and wave-like pressure marks in the spinal cord. 3.Vertebral artery type cervical spondylosis (1) The main symptoms are unilateral cervical occipital or occipital top episodes of headache, vision loss, tinnitus, hearing loss, vertigo, and sudden collapse episodes. It is often triggered or aggravated by head movement to a certain position, and vertigo attacks caused by head and neck rotation are the most characteristic of this disease. Vertebral artery flow test and vertebral arteriogram can assist in the diagnosis and identify whether the vertebral artery is normal, has compression, tortuosity, thinning or blockage. (2) X-ray examination can show vertebral joint instability and lateral hyperplasia of the hook vertebral joint. (4) Sympathetic cervical spondylosis (1) The main symptoms are headache or migraine, sometimes accompanied by nausea, vomiting, neck and shoulder pain, upper limb coldness and cyanosis, blurred eye vision, eye socket swelling and pain, eyelid weakness, pupil dilatation or narrowing, often tinnitus, hearing loss or loss. Persistent pressure pain or drilling pain in the precordial region, arrhythmia, tachycardia. (2) Symptoms can be significantly aggravated when the head and neck are rotated. Compression of the spinous processes of unstable vertebrae can induce or aggravate sympathetic symptoms. Class evidence differentiation 1.Neurogenic cervical spondylosis should be differentiated from ulnar neuritis, thoracic outlet syndrome, carpal tunnel syndrome and other diseases. 2.Spinal cord cervical spondylosis should be differentiated from spinal cord tumor, spinal cord cavernous disease and other diseases. 3.Vertebral artery type cervical spondylosis should be excluded from ophthalmogenic and otogenic vertigo and brain tumor and other diseases. 4. The diagnosis of simple sympathetic cervical spondylosis is more difficult and should be distinguished from coronary artery insufficiency and neurosis.