Cervical medullary epidural lesions are one of the clinical manifestations of spinal cord compression. Medullary compression refers to a group of conditions in which the spinal cord, spinal nerve roots and their supplying vessels are compressed by lesions of various natures. Differential diagnosis of cervical epidural lesions: 1. Complete cervical medullary injury: Cervical medullary injury is an injury to the cervical spinal cord caused by a cervical fracture, etc., which manifests as paralysis of the extremities and trunk to varying degrees, and urinary and fecal disorders. Patients often experience respiratory effort and chest tightness due to respiratory muscle paralysis, and are prone to dizziness, dizziness, and panic due to postural hypotension. Cervical medullary injury is divided into complete injury and incomplete injury according to the degree of injury. Complete injury means that there is no sensation when needling the anus, and there is no random contraction of the external anal sphincter when the anus is finger-pricked. Incomplete injury means that there is sensation when the needle punctures the anus, or there is a random contraction of the external anal sphincter when the anus is palpated. Usually the sensory function and motor function of the limb will be restored to different degrees after cervical medullary injury. 2.Superior cervical medullary lesion: The superior cervical medullary lesion is a lesion produced by a spinal cord tumor in the cervical spinal cord area II. The superior cervical medullary lesion may have occipital and cervical pain and abnormal sensation. 3, cervical medullary demyelinating lesion: cervical medullary demyelinating lesion is a disease in which the cervical medulla is compressed and damages the nerve center, which can invade the anterior horn cells of the spinal cord and the nuclei of the brainstem as well as the cone cells of the motor cortex of the brain in severe cases. First, it is obvious whether the spinal cord damage is compressive or non-compressive, and then determine the site and plane of compression, intramedullary, extramedullary intradural or epidural lesions; finally, determine the etiology and nature of the compressive lesion. (1) Longitudinal localization of the lesion: determined by the characteristics of the lesion in each segment of the spinal cord (as described in section I). Early segmental symptoms such as radicular pain, hyperalgesia, altered tendon reflexes and muscle atrophy, spinal pressure pain and percussion pain, especially in the sensory plane, have the most localization significance, and MRI or myelography can be accurately localized. (2) Transverse localization of lesions: differentiate whether the lesion is located in the intramedullary, intramedullary or epidural. (3) Determine the etiology and nature of the lesion: Intramedullary and extramedullary intradural lesions are most commonly tumors. The lesions caused by spinal arachnoiditis are often asymmetrical, sometimes mild and sometimes severe, and the sensory impairment is mostly radicular, segmental or plaque-like irregularly distributed, with obstruction on the compression neck test, increased protein content, and drop-like or plaque-like distribution of contrast agent on spinal canal imaging. Epidural lesions are mostly metastases, (lumbar segment, lower cervical segment) disc prolapse, metastases progress faster, root pain and bone destruction are obvious. Acute compressions are mostly traumatic epidural hematomas and epidural abscesses, the former progressing rapidly and the latter often with infectious features.