The Relationship Between Atypical Symptoms Of Degenerative Cervical Myelopathy And The Segments Of Spinal Cord Compression And Outcomes Of Treatment

Objective: To investigate the relationship between atypical symptoms and spinal cord compression segments in patients with degenerative cervical myelopathy(DCM),and to observe the efficacy of conservative and surgical treatment on atypical symptoms.Methods: 166 DCM patients with atypical symptoms admitted to our hospital from 2019 to 2020,were divided into the vertigo group,headache group,blurred vision group,tinnitus group and palpitation group according to their clinical manifestations;214 DCM patients without atypical symptoms admitted to our hospital during the same period were set up as the control group.The differences between the vertigo,headache,blurred vision,tinnitus and palpitation groups were compared with the control group in terms of spinal cord compression segments respectively,and the medium term efficacy of conservative and surgical treatment on various atypical symptom of DCM patients was summarized.Results: The prevalence of vertigo,headache,blurred vision,tinnitus and palpitations in patients with spinal cervical spondylosis was 37%,18%,15%,11% and 11% respectively.Patients in the blurred vision and tinnitus groups were older(57.4±9.2 vs 60.1±9.6,57.4±9.2 vs 61.0±8.8,P<0.05),compared to patients in the control group.In terms of cervical spinal cord compression segments,the incidence of C3-5 segmental compression was higher in the vertigo group than in the control group(32% vs 22%;56% vs 41%),the incidence of C4-5 segmental compression was higher in the headache group than in the control group(59% vs 41%),the incidence of C5-6 compression was lower in the palpitation group than in the control group(53% vs 77%),as well as the incidence of compression in segments C6-7 was higher(67% vs50%),with all differences being statistically significant(p < 0.05).Only the decrease in scores for vertigo and headache was statistically significant after conservative treatment(30.6±12 vs 29.1±11,4.7±2.5 vs 3.1±1.6,p<0.05),whereas the decrease in scores for dizziness,headache and palpitations were all statistically significant after decompression surgery(41.4±20 vs 26.6±11,5.7±2.9 vs 3.48±1.8,p <0.05,2.1±0.8 vs 1.0±0.9,p<0.05).Conclusion: Atypical symptoms were common in patients with DCM and the segments of spinal cord compression might be associated with specific atypical symptoms.Conservative treatment and surgical treatment are both effective in relieving some of the atypical symptoms.