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

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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.	顧韜, 王新偉, 袁文, 等. 頸椎間盤與后縱韌帶上交感神經分布的特點及臨床意義[J]. 中華實驗外科雜志, 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.	陳仲強, 張之虎. 頸性眩暈病例的椎動脈造影觀察[J]. 中華骨科雜志, 1991, 11(2):95-97.
8.	劉延青, 劉熙海, 孫宇, 等. 交感型頸椎病患者頸椎不穩定的X線測量[J]. 中國脊柱脊髓雜志, 2003, 13(10):600-603.
9.	劉延青, 張鳳山, 孫宇. 頸椎病患者突出椎間盤的MRI測量及臨床意義[J]. 中國脊柱脊髓雜志, 2004, 14(3):147-149.
10.	何海龍, 賈連順, 李家順, 等. 椎動脈阻斷對犬中樞神經系統功能的影響[J]. 中華醫學雜志, 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.	黃平, 陳德玉. 頸前路減壓術后頸椎重建的研究進展[J]. 中國矯形外科雜志, 2009, 17(11):841-842.
18.	張競, 袁文, 王新偉, 等. 頸前路減壓術后植骨重建研究[J]. 國外醫學·骨科學分冊, 2005, 26(6):360-362.
19.	梁磊, 王新偉, 袁文, 等. 前路經椎間隙減壓固定融合術治療伴交感神經癥狀頸椎病的療效分析[J]. 中國脊柱脊髓雜志, 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. 顧韜, 王新偉, 袁文, 等. 頸椎間盤與后縱韌帶上交感神經分布的特點及臨床意義[J]. 中華實驗外科雜志, 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. 陳仲強, 張之虎. 頸性眩暈病例的椎動脈造影觀察[J]. 中華骨科雜志, 1991, 11(2):95-97.
8. 劉延青, 劉熙海, 孫宇, 等. 交感型頸椎病患者頸椎不穩定的X線測量[J]. 中國脊柱脊髓雜志, 2003, 13(10):600-603.
9. 劉延青, 張鳳山, 孫宇. 頸椎病患者突出椎間盤的MRI測量及臨床意義[J]. 中國脊柱脊髓雜志, 2004, 14(3):147-149.
10. 何海龍, 賈連順, 李家順, 等. 椎動脈阻斷對犬中樞神經系統功能的影響[J]. 中華醫學雜志, 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. 黃平, 陳德玉. 頸前路減壓術后頸椎重建的研究進展[J]. 中國矯形外科雜志, 2009, 17(11):841-842.
18. 張競, 袁文, 王新偉, 等. 頸前路減壓術后植骨重建研究[J]. 國外醫學·骨科學分冊, 2005, 26(6):360-362.
19. 梁磊, 王新偉, 袁文, 等. 前路經椎間隙減壓固定融合術治療伴交感神經癥狀頸椎病的療效分析[J]. 中國脊柱脊髓雜志, 2012, 22(1):14-19.

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Clinical Analysis of Cervical Spondylosis Combined with Cervicogenic Vertigo

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