神经根型颈椎病（CSR）是一种由于颈椎间盘和椎间关节退变引起的疾病，主要表现为颈部、肩部及上肢神经支配区域的疼痛、感觉异常和运动障碍。传统中医的筋骨辨证在治疗该病时存在概念不清、辨证分型不一等问题。岐黄学者林定坤教授在筋骨辨证的基础上，结合现代解剖学提出了颈椎“筋”“节”“骨”“髓”4大分型。该文通过总结林定坤教授对CSR筋骨辨证学术思想，总结手法治疗该病的作用靶点，提出基于筋劳、节错、骨变和髓损等4种病损分型，采用理筋、调节、护髓和治骨4种手法治疗，以期完善骨伤科手法治疗CSR的辨证施治体系，为临床提供参考。

Cervical spondylotic radiculopathy（CSR）is a condition caused by the degeneration of cervical intervertebral discs and facet joints，primarily manifesting as the pain，sensory abnormalities，and motor dysfunction in the cervical nerve innervation area of neck，shoulder，and upper limb. For the treatment of CSR，tendon-bone syndrome differentiation in traditional Chinese medicine often faces the issues of conceptual confusion and non-standard syndrome differentiation. Based on the traditional tendon-bone syndrome differentiation and by integrating modern anatomical insights，Professor LIN Ding-Kun，an esteemed scholar of Traditional Chinese Medicine，proposed a classification system for the cervical spine that includes the categories of tendons，joints，bones and marrow. This paper explored the thoughts of Professor LIN for the tendon-bone syndrome differentiation of CSR，summarized the targets of manual therapy，and proposed the four kinds of pathological changes such as tendon overstrain，joint dislocation，bone lesion，and marrow injury，as well as the four techniques of traditional Chinese medicine manipulations，i.e. relaxation of tendons，reduction of joints，protection of marrow，and treatment of bones. The aim is to improve the syndrome-differentiation and treatment for CSR with orthopedic and traumatologic manipulations，and to provide reference for clinical practice.

R274.9

国家自然科学基金青年项目 （编号：82104895）；国家中医药管理局中医药领军人才项目岐黄学者项目 （编号：国中医药人教司[2022] 6号）；广东省中医药局科研专项资金项目 （编号：Z155080000004）；广州市科技计划项目 （编号：202201010974）；林定坤广东省名中医传承工作室建设项目 （编号：0103030912）；岭南骨伤流派传承工作室建设项目 （编号：E43607）；石仰山学术经验传承工作室建设项目 （编号：E43715）；广东省新黄埔中医药联合创新项目 （编号：2021IR008）；广州市颈椎力学生物学重点实验室项目 （编号：2024A03J0045）