Cervical spondylosis is a degenerative disease primarily characterized by neck pain, limited mobility, upper limb numbness, and even functional impairment. It falls within the scope of traditional Chinese medicine classifications such as “neck impediment syndrome,” “bone impediment syndrome,” and “sinew impediment syndrome.” Traditional Chinese medicine predominantly addresses this condition through macro-level differentiation and treatment approaches such as liver and kidney deficiency, invasion by wind-cold-damp pathogens, and blood stasis obstructing collaterals. While these methods yield reliable therapeutic outcomes, they offer relatively limited systematic interpretation of the local microstructures and functional states of the cervical spine. Based on the theory of Bone Xuanfu-Collaterals-Marrow, this paper explores the pathogenesis and treatment approaches of cervical spondylosis from an integrated perspective of macroscopic holism and microscopic structure. The theoretical connotations of “Bone Xuanfu”, “Collaterals” and “Marrow” are elaborated, as well as their internal relationships in the physiology and pathology of the cervical spine. After that, the pathogenesis and progression of cervical spondylosis are analyzed from three aspects: “obstruction of Bone Xuanfu,” “stasis of collaterals,” and “deficiency and malnourishment of marrow.” Finally, a staged treatment approach of “opening Xuanfu, nourishing collaterals, and replenishing bone marrow,” is proposed, which is discussed with corresponding therapeutic methods and herbal formulas. This aims to provide a novel theoretical perspective for the syndrome differentiation and treatment of cervical spondylosis within traditional Chinese medicine.
Yu Q, Shan J, Ma J, et al., 2025, Multi-Modal and Multi-View Cervical Spondylosis Imaging Dataset. Sci Data, 12(1): 1080.
Chang T, Wang Z, Lee X, et al., 2024, Risk of Cervical Dizziness in Patients With Cervical Spondylosis. JAMA Otolaryngol Head Neck Surg., 150(2): 93–98.
Guo W, Zhang J, Feng Y, 2024, Treatment of Neuropathic Pain by Traditional Chinese Medicine: An Updated Review on their Effect and Putative Mechanisms of Action. Phytother Res., 38(6): 2962–2992.
Ying C, He Y, Guo Y, et al., 2025, Application of Traditional Chinese Medicine in Alzheimer’s Disease Treatment: A Focus on the Wnt/[Formula: see text]-Catenin Pathway. Am J Chin Med., 53(6): 1641–1683.
Moghaddam A, Lin Z, Sivaguru M, et al., 2022, Heterogeneous Microstructural Changes of the Cervix Influence Cervical Funneling. Acta Biomater., 2022(140): 434–445.
Li L, Wang P, Liang H, et al., 2023, Design of a Haversian System-like Gradient Porous Scaffold based on Triply Periodic Minimal Surfaces for Promoting Bone Regeneration. J Adv Res., 2023(54): 89–104.
Sukhoplyasova M, Hamner J, Draghici A, 2025, The Role of Sympathetic Control in Bone Vasculature: Insights from Spinal Cord Injury. J Bone Miner Res., 40(3): 404–412.
Taheri S, Yoshida T, Böker K, et al., 2023, Changes of the Subchondral Bone Microchannel Network in Early Osteoarthritis. Osteoarthritis Cartilage, 31(1): 49–59.
Maksymowych W, 2023, Evidence in Support of the Bone Marrow as the Primary Lesion in Axial Spondyloarthritis. Curr Opin Rheumatol., 35(4): 213–218.
Mauro D, Gandolfo S, Tirri E, et al., 2023, The Bone Marrow Side of Axial Spondyloarthritis. Nat Rev Rheumatol., 19(8): 519–532.
Gan Y, Zhang P, Liao R, et al., 2022, Novel Interrupted Aortic Arch: A Case Report. J Card Surg., 37(12): 5639–5642.
Ravaillault S, Samarut E, Ploteau S, et al., 2025, Involvement of the Sinuvertebral Nerve in the Treatment of Chronic Low Back Pain through Dorsal Root Ganglion Neurostimulation: An Anatomical Study. Surg Radiol Anat., 47(1):160.
Tang H, Ni W, Niu D, et al., 2025, GuiQi Huoxue Capsule Alleviates Cervical Spondylosis in Rats: Insights from 16S rRNA Sequencing, Lipidomics, and Network Pharmacology. J Ethnopharmacol., 2025(347): 119752.
Feng Q, Tong L, Lu Q, et al., 2022, H NMR Serum Metabolomics and its Endogenous Network Pharmacological Analysis of Gushudan on Kidney-Yang-Deficiency-Syndrome Rats. Anal Biochem., 2022(643): 114580.
Li K, Ji Y, Shi J, et al., 2022, Examination of the Microstructures of the Lower Cervical Facet Based on Micro-Computed Tomography: A Cadaver Study. Medicine (Baltimore), 101(50): e31805.
Hao Y, Ma Y, Zhang S, et al., 2025, Study of Distribution and Morphological Characteristics of the Trabecular Bone in the Uncinate Process of the Cervical Spine using Micro-Computed Tomography. PLoS One, 20(1): e0315640.
Tamura R, Tanaka T, Akasaki Y, et al., 2019, The Role of Vascular Endothelial Growth Factor in the Hypoxic and Immunosuppressive Tumor Microenvironment: Perspectives for Therapeutic Implications. Med Oncol., 37(1): 2.
Liu S, Wang Z, Su Y, et al., 2021, A Neuroanatomical Basis for Electroacupuncture to Drive the Vagal-Adrenal Axis. Nature, 598(7882): 641–645.
Wang T, Hurwitz O, Shimada S, et al., 2015, Chronic Compression of the Dorsal Root Ganglion Enhances Mechanically Evoked Pain Behavior and the Activity of Cutaneous Nociceptors in Mice. PLoS One., 10(9): e0137512.
Badhiwala J, Ahuja C, Fehlings M, 2018, Time is Spine: A Review of Translational Advances in Spinal Cord Injury. J Neurosurg Spine, 30(1): 1–18.
Liu F, Ou H, Fan F, et al., 2025, Discussion on the Prescription and Clinical Application of Mahuang Shengma Decoction Based on “Xuanfu-Yingwei” Theory. Jiangsu Journal of Traditional Chinese Medicine, 57(5): 65–68.
Wei P, Huo H, Ma Q, et al., 2014, Pharmacokinetic Comparisons of Five Ephedrine Alkaloids Following Oral Administration of Four Different Mahuang-Guizhi Herb-Pair Aqueous Extracts Ratios in Rats. J Ethnopharmacol., 155(1): 642–648.
Li J, Wang F, Ji J, et al., 2025, Clinical Efficacy of Copper Gua Sha Therapy Based on the “Qi Channel Discharge” Concept for Cervical Spondylosis with Qi Stagnation and Blood Stasis in Elderly Patients. Medicine (Baltimore), 104(44): e45243.
Jiang S, Yang S, Meng L, et al., 2025, Analgesic Effects of Acupressure on Jing-Jiaji Acupoints in a Rat Model of Cervical Spondylotic Radiculopathy. Mol Neurobiol., 62(9): 12270–12279.
Zhu H, Liu Q, Li W, et al., 2022, Biological Deciphering of the “Kidney Governing Bones” Theory in Traditional Chinese Medicine. Evid Based Complement Alternat Med., 2022(2022): 1685052.
Yang A, Yu C, You F, et al., 2018, Mechanisms of Zuogui Pill in Treating Osteoporosis: Perspective from Bone Marrow Mesenchymal Stem Cells. Evid Based Complement Alternat Med., 2018(2018): 3717391.