What kind of cervical spine patients need surgical treatment? Cervical spondylosis is divided into spinal cord type, nerve root type, vertebral artery type, sympathetic nerve type and mixed type according to the site of compression; and sudden onset type, progressive aggravation type, stable type and self-limited type according to the time of onset. Most of the cases requiring surgery are spinal cord cervical spondylosis. The main manifestations of spinal cord cervical spondylosis are neck pain, arm numbness, weakness in walking and change in gait. It can be divided into early and late manifestations. Early stage: numbness of hands or feet, slowing down or disappearance of rapid and fine movements (such as fastening buttons, serving bowls, holding chopsticks, etc.), unstable or weak walking, difficulty in tandem gait, decreased proprioception, mild hyperreflexia, mild clonus, positive Hoffman’s sign in posterior cervical extension; late stage: difficulty in conventional gait, marked motor deficit, marked impairment of balance, marked hyperreflexia In the late stage, there is a continuous paroxysm with positive Babinski’s sign. For patients with stable and self-limited forms, conservative treatment is effective, which means that not all patients with cervical spondylosis require surgery. Which patients need surgery? 1. Clinical manifestations, at least early ones (see previous section); 2. MRI with spinal cord compression. For early spinal cord cervical spine patients, it is also possible to observe while treating conservatively, and if there are signs of aggravation, surgery should be performed early.