Neck and shoulder pain with numbness of limbs is a series of symptoms caused by compression and stimulation of nearby spinal cord and blood vessels by cervical lesions. Common ones are: (1) cervical spondylotic radiculopathy is caused by the protrusion or prolapse of cervical intervertebral disc and the proliferation of uncinate joint or facet joint pressing the nerve root. The main manifestations are neck and shoulder pain with pain and numbness in one or both upper limbs. In severe cases, muscle atrophy, muscle weakness and poor fine finger movements may occur. Bile reflex involving nerve roots is active in the early stage, weakened or disappeared in the middle and late stage, but bilateral comparison should be paid attention to. Jacking test, intervertebral foramen compression test and nerve root traction test can be positive. X-ray examination showed cervical instability, hyperosteogeny at the posterior edge of vertebral body, narrowing of intervertebral space, proliferation of uncinate joint and stenosis of intervertebral foramen. This disease generally does not require CT or MRI examination. (2) Cervical spondylotic myelopathy is a series of symptoms caused by spinal cord compression. If the front of the spinal cord is compressed, the patient will feel heavy lower limbs, unable to move, and difficult to walk, such as the feeling of leggings, unsteady walking, shy gait, and in severe cases, may be weak. If the main symptom is cervical spinal canal stenosis, the first symptom is sensory disturbance, and the upper limbs gradually develop into numbness and pain in the limbs, which continues. After a few weeks or months, the above-mentioned dyskinesia will appear. If one side of the spinal cord is severely compressed, Brown-Sequard sign will appear, and the limb spasm, weakness and voluntary movement on the compressed side will disappear, while the pain and temperature sensation on the opposite side will disappear. The plane where the sensation disappears is inconsistent with the compressed plane of the spinal cord, and both sides will have hyperreflexia, and the bones and ankles will be positive. Hoffman, Babinsky, chaddock, oppenheim and Palmer were positive for frontal reflex. Abdominal wall reflex and testicular reflex can be reduced or disappeared, which can cause muscle atrophy and defecation dysfunction in severe cases. If the carotid artery is compressed or stimulated, it will first show the symptoms of the upper limbs, and then it will involve the lower limbs, but the symptoms of the lower limbs are still the most serious. If the surface of the cervical pyramidal tract is compressed, it will first involve the lower limbs and then the upper limbs, but the symptoms of the lower limbs are still the most serious. If the anterior central artery of the cervical spinal cord is compressed or stimulated, the upper and lower limbs will develop simultaneously, but the lower limbs are the most important. The patients with anterior cervical spinal cord compression are mainly dyskinesia, while those with posterior cervical spinal cord compression are mainly sensory disturbance. X-ray plain film can show hyperosteogeny, instability of vertebral segment, narrowing of intervertebral space and sagittal diameter of spinal canal. Myelography is helpful to determine the location, degree and scope of compression, and can distinguish intraspinal tumors, arachnoiditis and spinal vascular malformations. However, due to the development of CT, especially MRI, this method is gradually decreasing. CT can clearly show the bone spur and the posterior longitudinal ligament. After myelography, CT can observe the state of the spinal canal, the whole view of the spinal cord section and whether there are space-occupying lesions. The appearance of MRI is of epoch-making significance for the diagnosis and treatment of cervical spondylotic myelopathy. It can clearly show the compression, injury, cavity and degeneration of the spinal cord, and can clearly reflect the extent and degree of cervical disc herniation and inflammatory reaction or abscess around the spinal canal. (3) Vertebral artery type cervical spondylosis is caused by cervical instability, intervertebral disc degeneration or prolapse. Vertebral artery is compressed or stimulated by uncinate process joint hyperplasia or its joint capsule congestion and edema, arteriosclerosis and other factors, resulting in vertebral artery spasm. A series of clinical symptoms such as stenosis and flexion caused by vertebrobasilar artery insufficiency. In addition to conscious neck and occipital pain, patients mainly show insufficient blood supply to the basilar artery, such as migraine, dizziness, tinnitus, hearing loss, vision loss, disturbance of consciousness, autonomic nervous disorder and so on, and a few patients may have difficulty in making sound. The above symptoms of vertebrobasilar ischemia are often positive in neck rotation induction test. Attention should be paid to consulting ophthalmology and otology to exclude eye-borne or otogenic diseases. Patients with dysphonia should rule out laryngeal diseases and lateral sclerosis. Also pay attention to whether the trachea is centered to distinguish whether there is a retrosternal tumor. X-ray film shows instability and degeneration of cervical spine. Pay attention to whether there is a depression in the bottom of the neck when lying on the side. Vertebral artery rheogram is for reference only. Vertebral arteriography can make a definite diagnosis and prompt the choice of surgical methods, but its technical requirements are high, it has not been popularized and has certain trauma. In recent years, with the introduction of MRI, MRI examination of vertebral artery can provide clearer images, which is of great help to cervical spondylosis of vertebral artery type, but it is expensive and difficult to popularize. (4) Vertebral-basilar artery ischemia symptoms caused by head and neck impact in traumatic uncinate process arthropathy. Trauma of uncinate process joint leads to edema, congestion, fibrosis and even ossification of soft tissue, and instability of uncinate process joint leads to compression or stimulation of vertebral artery and neck pain. Activity restriction, migraine, dizziness, and sometimes nausea and vomiting. There may be tenderness and percussion pain in the injured cervical vertebra, and the stroke test is negative, the neck rotation test is negative, and the neck nystagmus is mostly positive. EEG is normal. No special manifestations were found in X-ray film, but vertebral artery angiography or MRI showed its compression performance. (5) Tumors in the cervical spinal canal Benign tumors in the cervical spinal canal are more common in schwannomas, meningiomas, hemangiomas and lipomas, and most of them are gliomas. When the tumor is small, the sinus nerve is stimulated first to cause neck and shoulder pain. When the tumor grows and compresses the nerve roots, it causes pain, numbness and muscle weakness in the upper limbs. Patients may be aggravated by suffocation or cough. This symptom is aggravated at night and can be alleviated during the day or when the work is busy. With the gradual enlargement of the tumor, the spinal cord can be compressed, and different signs can be produced according to the different compression sites. Clinically, there are compression of anterior horn and posterior horn of spinal cord, Brown-Sequard spinal cord hemisection syndrome and so on. At this stage, if the compression is relieved by surgery, the spinal cord function can be restored. If the tumor continues to grow and the spinal cord is completely compressed, the prognosis will be poor. X-ray plain films generally have no positive findings. Myelography showed that the tumor was a "cup" defect, which was not in the same plane as the intervertebral space. After contrast, CT can still show the size of the tumor, epidural space, medullary cavity and MRI can show the shape, size and exact location of the tumor more clearly, and can observe the compression of the spinal cord, so early examination should be made.