Abstract:Osteoporotic cervical spondylosis（OCS）is a complex disease characterized by cervical degenerative changes and bone metabolism imbalance, with its pathogenesis involving multi-system interactions such as disruption of bone homeostasis, intervertebral disc degeneration, and neurovascular compression. Klotho, a type Ⅰ transmembrane protein, serves as a critical component of the fibroblast growth factor receptor 1（FGFR1）complex. In recent years, Klotho protein has become a research focus due to its central roles in anti-aging effects, regulation of calcium-phosphorus metabolism, and maintenance of bone homeostasis. Emerging studies confirm that Klotho, a key regulator of aging and mineral ion homeostasis, exhibits properties including inflammation suppression, anti-tumor effects, and endocrine system modulation, further highlighting its potential as an ideal molecular candidate for clinical bone repair. This article synthesizes research advances from the past five years, systematically reviews Klotho??s role in OCS through the fibroblast growth factor 23（FGF23）signaling axis, and explores its therapeutic potential, thereby providing a theoretical foundation for precision intervention in OCS.