There is no evidence that the long-term outcome of surgical treatment is better than the long-term outcome of non-surgical treatment, but patients with moderate or severe spinal cord damage (JOA score <15) or progressive worsening of spinal cord damage should receive surgical treatment. The primary goal of surgery is to prevent further deterioration of spinal cord damage or improve neurological function by enlarging the spinal canal to relieve compression of the spinal cord and its blood circulation. Cervical spine stability is maintained through fusion and other means to prevent spinal cord injury caused by abnormal cervical spine movement and to prevent cervical deformity. The choice of surgical option depends on the lesion segment, severity of the lesion, cervical sagittal force lines, cervical stability, previous surgical history, and the surgeon's surgical proficiency. No single factor predicts disease progression in spinal cervical spondylosis, but there is evidence that surgery improves the long-term prognosis of the disease to some extent. In contrast, once the decision to operate has been made, treatment should be provided as soon as possible, especially for those patients with progressive exacerbation of symptoms, and the earlier the surgery, the better the prognosis. The only factor associated with postoperative function has been reported in the literature to be the duration of preoperative symptoms, and patients operated on within one year of symptom onset had better surgical outcomes than those who had been symptomatic for longer. Decompression of spinal cervical spondylolisthesis is accomplished by removing the bone, disc, or ligamentous structures that occupy the spinal canal space. Decompression can usually be performed through a posterior or an anterior cervical approach. Posterior decompression is accomplished primarily through posterior cervical laminectomy (LAMT) or laminoplasty (LAMP) to decompress the spinal cord dorsally. LAMT allows reconstruction of the vertebral plate without fusion, preserving the integrity of the cervical spine while decompressing the spinal cord, maintaining the stability and mobility of the cervical spine, and reducing the risk of postoperative cervical lordosis. 2.Anterior decompression The anterior cervical discectomy with fusion (ACDF) and anterior cervical corpectomy with fusion (ACCF) are mainly used. ACCF is indicated for spinal cord damage caused by single-segment or some multi-segment disc herniation. single or multiple vertebral bodies and adjacent discs and fusion of the adjacent vertebral bodies. ACDF, ACCF, LAMT, and LAMP have similar near-term prognoses, but the choice of surgical approach depends on many factors. The first is anatomic, with the posterior approach commonly used for cases where compression is from the posterior aspect of the spinal cord, such as a posterior osteophyte or hypertrophic ligamentum flavum, while the anterior approach is commonly used to remove discs, anterior osteophytes, thickened or ossified posterior longitudinal ligaments, and other compressors from the anterior aspect of the spinal cord. However, both approaches allow for adequate decompression regardless of the site of compression. In addition to anatomic factors there are several other factors that influence the choice of surgical approach. The anterior approach is more helpful in restoring the anterior cervical curve, and for patients with preoperative cervical kyphosis, an anterior or combined anterior and posterior approach is recommended to restore the anterior cervical curve. A posterior approach is not an appropriate option for patients with cervical kyphosis. When the spinal cord is severely compressed both anteriorly and posteriorly, a combined anterior-posterior approach should be chosen.