In cervical spine surgery, the surgical field involves important structures such as the spinal cord, nerve roots, vertebral artery, and esophagus, and injury to any of these structures will lead to more serious consequences. Traditionally, large incisions and wide exposure are often used for surgical safety, resulting in high surgical trauma and postoperative complications. With the advancement of concepts and surgical techniques, cervical spine surgery is a progressive minimally invasive process from posterior long-segment laminectomy → posterior single-opening surgery → anterior cervical slotting and decompression → anterior cervical discectomy and decompression → artificial disc replacement in the cervical spine. Spine surgery tends to be minimally invasive, and minimally invasive often means a small surgical field of view, which requires a higher level of surgeon’s surgical skill and experience. With the use of the operating microscope, the safety of cervical spine surgery has been further guaranteed. The surgical microscope was first introduced in 1967 by Yasargil at the University of Zurich, Switzerland, and was first used in lumbar disc surgery and gradually developed into cervical surgery, where it has become a valuable adjunct to spine surgery. The use of microsurgery in cervical spine surgery has natural advantages: 1. Anterior cervical surgery is a small field of view, the main surgeon and assistant often interfere with each other, affecting the operation; at the same time, due to the operation immediately adjacent to the cervical medullary nerve, the incision is narrow, the site is deep in, increasing the risk of surgery. The surgical microscope can magnify the operative field by more than 2-5 times according to the specific situation, which can clearly separate the spinal cord, nerves, blood vessels and surrounding ligamentous tissues and reduce the risk of intraoperative injury. 2.Operative field illumination. Due to the small incision in the anterior cervical surgery, it is difficult for the surgical light to enter the incision well. The microscope comes with a high-brightness light source, which can shine into the field of view with the lens, so that the main surgeon and the assistant can clearly see the surgical site without interfering with each other, which is conducive to cooperative operation. 3.Camera function. Through the video system of the operating microscope can provide a good teaching role. 4.Minimally invasive. The microscope does not need to remove and destroy more normal tissues to achieve further minimally invasive. In conclusion, microsurgery technology has increased the safety and convenience of cervical spine surgery, and also expanded the indications for cervical spine surgery. Moreover, through the application of microsurgical techniques, some conventional open surgeries can be accomplished through minimally invasive surgical approaches. For cervical spine surgery, the safety of surgery and thorough and effective decompression is the primary consideration. For cervical spine disease, the main causes of nerve compression are often osteophytes, herniated disc calcification, ossification of the posterior longitudinal ligament of the cervical spine, etc. The operating microscope provides direct projection light source, three-dimensional direct vision image, and amplification of the surgical field, and in conjunction with high-speed power equipment, it is fully capable of achieving a safe and effective decompression. Indications for operating microscope: 1, the type of lumbar disc herniation used; 2, anterior and posterior surgery for cervical spondylosis; 3, thoracic and lumbar spinal stenosis; 4, intramedullary and extramedullary lesions such as intravertebral tumors. In a sense, the operating microscope provides another safety guarantee for cervical spine surgery. Of course, what is more important is the rich surgical experience and advanced minimally invasive concept of the chief surgeon. The orthopedic department of Guangdong Provincial People’s Hospital has rich experience in spine surgery, and I have undergone many formal microscope and minimally invasive operation training. We welcome all patients with cervical spondylosis to come and see us.