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Introduction Cervical spondylosis(CS) is a common disease of adult and may coexist with amyotrophic lateral sclerosis (ALS), it is important to detect the coexistence of ALS at early stage to avoid unnecessary surgical treatment.Methods Single fiber electromyography(SFEMG) was performed in 26 patients with ALS, 19 ALS patients coexisting with evidence of spondylotic changes on MRI, and 22 patients with CS.