Objective: To explore the value of DTI technical parameters in predicting postoperative motor function recovery of cervical spondylotic myelopathy (CSM). Methods: 32 patients with CSM and 32 normal patients who underwent surgical treatment were selected for routine magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) before and after surgery; the preoperative and postoperative centers were compared between the two groups Anterior gyrus (PrCG), central posterior gyrus (PoCG) activation volume (VOA) values and spinal cord anisotropy score (FA) values; statistical analysis of various DTI indicators and the Japanese Orthopedic Association scoring system (JOA) score Correlation; analysis of the ROC curve of DTI indicators predicting poor recovery after CSM and factors of poor recovery after CSM. Results: (1) Postoperative JOA score of CSM patients was significantly greater than preoperative (P<0.05), PrCG of preoperative CSM group was significantly greater than that of control group, FA was significantly smaller than control group (P<0.05); CSM group compared postoperatively with preoperative , PrCG decreased significantly, FA increased significantly (P<0.05); (2) There was a significant correlation between the DTI indicators and the preoperative JOA score, postoperative score improvement rate (P<0.05), VOA ratio and The correlation coefficient of postoperative score improvement rate is the largest; (3) All CSM patients are divided into good group and bad group according to JOA score improvement rate during the postoperative follow-up. The cross-sectional area (CSA), FA, PrCG and VOA ratios of the 2 groups of patients The difference was statistically significant (P<0.05); the AUC area of VOA ratio was the largest; (4) VOA ratio and FA value were the risk factors for predicting poor recovery after CSM. Conclusion: The VOA ratio and FA value in DTI technology are the risk factors for predicting postoperative motor function recovery in CSM patients.