Study design: A prospective study was conducted in 48 patients with cervical spondylosis with incomplete cord injury to assess the role of decompression in these patients.Objectives: To evaluate surgical and nonsurgical outcomes in patients with pre-existing cervical spondylosis of the spine,in whom an incomplete spinal cord syndrome developed after a minor neck injury.Summary of background data: The benefits of surgical treatment of incomplete cord injury with cervical spondylosis are controversial but remains a treatment option.The results of this study clarified the benefits of surgery in such patients.Methods: Radiographic findings and outcomes based on post-spinal injury motor function score were compared retrospectively in 48 patients with cervical spondylosis.Twenty-six patients were treated operatively and 22 were treated nonoperatively.Results: The neurologic conditions of 21 of the 26 patients (80.8%) treated surgically improved within 2 days of surgery.Comparing the improvement of the two groups at defined intervals,there were statistically significant differences (P < 0.05) between the surgical and nonsurgical patients at 1-month and 6-month follow-ups.Nevertheless,14 of the 22 patients (63.6%) treated nonoperatively had recovered to at least muscle Grade 3 at the 2-year follow-up,but their recovery was slower than that of the surgical group.Conclusion: Although neurologic improvement after an incomplete spinal cord injury when no bony lesion was present was slow during the first few months after trauma,more than 60% of the patients showed neurologic recovery with a muscle grade higher than 3 at 2-year follow-up.Surgical decompression,however,was associated with immediate neurologic improvement,faster recovery of neurologic function,early mobilization,better long-term neurologic outcome,briefer hospital stays,and fewer complications related to long confinements in bed than was nonoperative treatment.