Clinical Analysis of Cervical Spondylosis Combined with Cervicogenic Vertigo_West China Medical Journal

Authors：

 FANGKai ,  FENGDa-xiong , ZHAOJia-ping

Department of Spinal Surgery, the Affiliated Hospital of Luzhou Medical College, Luzhou, Sichuan 646000, P. R. China;

Corresponding author：

FENGDa-xiong, Email: fdxlz2002@163.com

Keywords：

Cervicogenic vertigo; Features; Pathogenesis; Treatment

DOI：

10.7507/1002-0179.20140446

Video：

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Objective To explore the pathogenesis of cervical spondylosis combined with cervicogenic vertigo, and to investigate the clinical results of anterior discectomy and fusion in treating the disease. Methods A retrospective study was performed on 83 patients with cervical spondylosis myelopathy (n=60, 72%) or radiculopathy (n=23, 37.3%) accompanied by sympathetic symptoms such as dizziness between March 2008 and November 2012. The disease involved single segment in 29 cases, double segment in 50 cases, and triple in 4 cases. All the segments involved were treated with anterior discectomy and fusion. Vertigo alleviation was observed before surgery, 3 days after surgery, and during the final follow-up. Neurological status was evaluated by Japanese Orthopedic Association (JOA) score system and sympathetic symptoms were evaluated with vertigo symptom and function scoring system. Results The average follow-up was 21 months (ranging from 12 to 30 months). Significant difference was observed between sympathetic symptom scores and JOA scores before surgery and 3 days after surgery or at the final follow-up (P<0.05), but no significant difference was found between the scores 3 days after surgery and during the final follow-up (P>0.05). Conclusion The surgical effect for cervicogenic vertigo is often accompanied by the relief of spinal cord and nerve roots symptoms. Surgery is effective for cervical spondylosis combined with cervicogenic vertigo.

Citation： FANGKai, FENGDa-xiong, ZHAOJia-ping. Clinical Analysis of Cervical Spondylosis Combined with Cervicogenic Vertigo. West China Medical Journal, 2014, 29(8): 1450-1453. doi: 10.7507/1002-0179.20140446 Copy

1.	Hain TC. Vertigo and disequilibrium. Current treatment in neurologic disease[M]. 5 th. New York:Oxford University Press, 2002:446-470.
2.	Ryan GM, Cope S. Cervical vertigo[J]. Lancet, 1955, 269(6905):1355-1358.
3.	Cope S, Ryan GM. Cervical and otolith vertigo[J]. J Laryngol Otol, 1959, 73(2):113-120.
4.	Fukui M, Chiba K, Kawakami M, et al. JOA back pain evaluation questionnaire (JOABPEQ)/JOA cervical myelopathy evaluation questionnaire (JOACMEQ). the report on the development of revised versions. April 16, 2007. the subcommittee of the clinical outcome committee of the Japanese orthopaedic association on low back pain and cervical myelopathy evaluation[J]. J Orthop Sci, 2009, 14(3):348-365.
5.	顾韬, 王新伟, 袁文, 等. 颈椎间盘与后纵韧带上交感神经分布的特点及临床意义[J]. 中华实验外科杂志, 2007, 24(6):665-668.
6.	Brown JJ. Cervical contribution to balance:cevical vertigo[M]//Berthoz A, Graf W, Vidal P. The head-neck sensory motor system. New York:Oxford University Press, 1992:644-647.
7.	陈仲强, 张之虎. 颈性眩晕病例的椎动脉造影观察[J]. 中华骨科杂志, 1991, 11(2):95-97.
8.	刘延青, 刘熙海, 孙宇, 等. 交感型颈椎病患者颈椎不稳定的X线测量[J]. 中国脊柱脊髓杂志, 2003, 13(10):600-603.
9.	刘延青, 张凤山, 孙宇. 颈椎病患者突出椎间盘的MRI测量及临床意义[J]. 中国脊柱脊髓杂志, 2004, 14(3):147-149.
10.	何海龙, 贾连顺, 李家顺, 等. 椎动脉阻断对犬中枢神经系统功能的影响[J]. 中华医学杂志, 2002, 82(6):418-421.
11.	Michels T, Lehmann N, Moebus S. Cervical vertigo——cervical pain:an alternative and efficient treatment[J]. J Altern Complement Med, 2007, 13(5):513-518.
12.	Brown FM. Vertigo due to increased middle ear pressure:six-year experience of the Aeromedical Consultation Service[J]. Aerosp Med,1971,42(9):999-1001.
13.	Rajasekharan C, Thomas V, Parvathy R, et al. Condylus tertius and episodic vertigo:is there an asssociation[J/OL]. BMJ Case Rep, 2013. http://doi/org/10.1136/bcr-2013-009842.
14.	White AR, Johnson RM, Panjabi MM, et al. Biomechanical analysis of clinical stability in the cervical spine[J]. Clin Orthop Relat Res, 1975(109):85-96.
15.	Cho EI, White JA. Positional vertigo:as occurs across all age groups[J]. Otolaryngol Clin North Am, 2011, 44(2):347.
16.	Ren L, Guo B, Zhang J, et al. Mid-term efficacy of percutaneous laser disc decompression for treatment of cervical vertigo[J]. Eur J Orthop Surg Traumatol, 2014, 24(Suppl 1):153-158.
17.	黄平, 陈德玉. 颈前路减压术后颈椎重建的研究进展[J]. 中国矫形外科杂志, 2009, 17(11):841-842.
18.	张竞, 袁文, 王新伟, 等. 颈前路减压术后植骨重建研究[J]. 国外医学·骨科学分册, 2005, 26(6):360-362.
19.	梁磊, 王新伟, 袁文, 等. 前路经椎间隙减压固定融合术治疗伴交感神经症状颈椎病的疗效分析[J]. 中国脊柱脊髓杂志, 2012, 22(1):14-19.

1. Hain TC. Vertigo and disequilibrium. Current treatment in neurologic disease[M]. 5 th. New York:Oxford University Press, 2002:446-470.
2. Ryan GM, Cope S. Cervical vertigo[J]. Lancet, 1955, 269(6905):1355-1358.
3. Cope S, Ryan GM. Cervical and otolith vertigo[J]. J Laryngol Otol, 1959, 73(2):113-120.
4. Fukui M, Chiba K, Kawakami M, et al. JOA back pain evaluation questionnaire (JOABPEQ)/JOA cervical myelopathy evaluation questionnaire (JOACMEQ). the report on the development of revised versions. April 16, 2007. the subcommittee of the clinical outcome committee of the Japanese orthopaedic association on low back pain and cervical myelopathy evaluation[J]. J Orthop Sci, 2009, 14(3):348-365.
5. 顾韬, 王新伟, 袁文, 等. 颈椎间盘与后纵韧带上交感神经分布的特点及临床意义[J]. 中华实验外科杂志, 2007, 24(6):665-668.
6. Brown JJ. Cervical contribution to balance:cevical vertigo[M]//Berthoz A, Graf W, Vidal P. The head-neck sensory motor system. New York:Oxford University Press, 1992:644-647.
7. 陈仲强, 张之虎. 颈性眩晕病例的椎动脉造影观察[J]. 中华骨科杂志, 1991, 11(2):95-97.
8. 刘延青, 刘熙海, 孙宇, 等. 交感型颈椎病患者颈椎不稳定的X线测量[J]. 中国脊柱脊髓杂志, 2003, 13(10):600-603.
9. 刘延青, 张凤山, 孙宇. 颈椎病患者突出椎间盘的MRI测量及临床意义[J]. 中国脊柱脊髓杂志, 2004, 14(3):147-149.
10. 何海龙, 贾连顺, 李家顺, 等. 椎动脉阻断对犬中枢神经系统功能的影响[J]. 中华医学杂志, 2002, 82(6):418-421.
11. Michels T, Lehmann N, Moebus S. Cervical vertigo——cervical pain:an alternative and efficient treatment[J]. J Altern Complement Med, 2007, 13(5):513-518.
12. Brown FM. Vertigo due to increased middle ear pressure:six-year experience of the Aeromedical Consultation Service[J]. Aerosp Med,1971,42(9):999-1001.
13. Rajasekharan C, Thomas V, Parvathy R, et al. Condylus tertius and episodic vertigo:is there an asssociation[J/OL]. BMJ Case Rep, 2013. http://doi/org/10.1136/bcr-2013-009842.
14. White AR, Johnson RM, Panjabi MM, et al. Biomechanical analysis of clinical stability in the cervical spine[J]. Clin Orthop Relat Res, 1975(109):85-96.
15. Cho EI, White JA. Positional vertigo:as occurs across all age groups[J]. Otolaryngol Clin North Am, 2011, 44(2):347.
16. Ren L, Guo B, Zhang J, et al. Mid-term efficacy of percutaneous laser disc decompression for treatment of cervical vertigo[J]. Eur J Orthop Surg Traumatol, 2014, 24(Suppl 1):153-158.
17. 黄平, 陈德玉. 颈前路减压术后颈椎重建的研究进展[J]. 中国矫形外科杂志, 2009, 17(11):841-842.
18. 张竞, 袁文, 王新伟, 等. 颈前路减压术后植骨重建研究[J]. 国外医学·骨科学分册, 2005, 26(6):360-362.
19. 梁磊, 王新伟, 袁文, 等. 前路经椎间隙减压固定融合术治疗伴交感神经症状颈椎病的疗效分析[J]. 中国脊柱脊髓杂志, 2012, 22(1):14-19.

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Clinical Analysis of Cervical Spondylosis Combined with Cervicogenic Vertigo

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