Differential diagnosis of spinal cord cervical spondylosis: Any lesion with spinal cord irritation or damage must be differentiated from CSM. Cervical spine fracture dislocation, cervical spine subluxation, cervical spine congenital malformation, cervical spine bone tuberculosis, bone tumor, etc. can be differentiated from plain radiographs. In addition, the following diseases must be distinguished from this disease. 1, spinal cord tumor: Patients may have pain or numbness in the neck, shoulder, occiput, arm and fingers, with lower motor neuron damage in the ipsilateral upper limb and upper motor neuron damage in the lower limb. The symptoms gradually develop to the contralateral lower limb and finally reach the contralateral upper limb. Sensory loss and motor deficits below the plane of compression begin as a manifestation of Brown-Se-guard syndrome, gradually worsen, and finally present as transverse spinal cord damage. Differentiation: (1) X-ray shows enlarged intervertebral foramen, enlarged spinal canal, destruction of vertebral body or arch, and paravertebral soft tissue shadow (tumor shadow). (2) Myelography: It can provide direct imaging evidence of whether there is obstruction in the subarachnoid space, and can determine the plane and degree of obstruction. (3) Cerebrospinal fluid examination and kinetic test: lumbar puncture has certain risk for intravertebral canal tumor, and the condition can be suddenly aggravated after releasing fluid. Therefore, lumbar puncture should be performed with caution when intraspinal occupancy is suspected, and the release of fluid should be slow. In cases of complete obstruction, the cerebrospinal fluid is yellow in color, easily coagulated, and has an increased protein content. (4) MRI examination: It is the most valuable diagnostic method and has guiding significance for surgical resection of tumor. Enhancement scan done after injection of paramagnetic contrast agent Gd-DTPA can show paramagnetic field effect on T1-weighted image and enhance the signal intensity of tumor. The imaging changes are the same as CT scan, but it shows the tumor and its surrounding structures more clearly than CT scan. 2.Spinal cord cavernous disease: Mostly seen in young people, it usually occurs in the cervical spinal cord, with a long and slow development, separation of pain and temperature sensation from touch sensation, especially the loss or disappearance of temperature sensation, without subarachnoid obstruction. The diagnosis can be confirmed by CT or MRI examination. 3, spinal arachnoiditis: the onset of the disease is usually preceded by a history of infection or fever, with a long and fluctuating course, and neurogenic pain is rare. The cerebrospinal fluid is high in protein and has an increased cell count. MRI shows T1-weighted images of thickening of the spinal cord and narrowing of the subarachnoid space in the early stages of the lesion, with long abnormal T1 signals along the spinal canal on the dorsal side of the spinal cord after a period of time. 4, amyotrophic lateral sclerosis: Patients first have symptoms in the upper extremities, due to the development of the elbow and shoulder, then to the contralateral upper extremities, and then to the lower extremities. Examination revealed atrophy of the interosseous muscles of the hands, even inability to hold things and buckle, but no sensory impairment; myospasm and pathological reflexes in the lower limbs; myelogram was clear. If the disease develops further, the patient’s speech will be slurred, and the back of the tongue may obstruct the airway, with a poor prognosis. 5, posterior longitudinal ligament ossification: Key first reported this disease in 1938, and Japan proposed in 1960 that this disease can cause severe spinal cord dysfunction. The ossification can be divided into continuous, interrupted, mixed and isolated types. As a result of ossification of the posterior longitudinal ligament, the spinal canal becomes narrow, affecting the blood circulation of the spinal cord, and in severe cases, the spinal cord may be compressed, resulting in paralysis. The disease can coexist with cervical spondylosis. CT scan can accurately understand the morphology, maturity, location, extent of ossification of the posterior longitudinal ligament, and compression of the spinal cord.