Clinical Research On The Relationship Between Cervical Instability And The Pathogenesis Of Youth Cervical Vertigo

Objectives:1. to explore the function of cervical instability in the pathogenesisof youth cervical vertigo, by measuring and analyzing the cervical imagingdata of youth cervical vertigo group and neck symptoms group.2. to summarize the characteristics of cervical instability onyouth cervical vertigo and provide the help for clinical diagnosis andtreatment of youth cervical vertigo, by analyzing the clinical manifestationsand imaging data of youth, middle-aged patients suffered by cervical vertigo.Methods:Sixty-two patients diagnosed as cervical vertigo were divided into youthgroup （16-40years） and middle-aged group （>40years） according to differentages. Thirty-one young patients （16-40years） suffered by neck discomfort,such as the pain and limited mobility of neck and shoulder, were selected intothe symptomatic group in the same time. The data of patients selected wasrecorded, mainly including their occupation, medical history, clinicalmanifestations and related physical examination. All patients were analyzedon routine, dynamic hyperextension and hyperflexion radiography. Horizontaldisplacement （HD）, angular displacement （AD） and cervical curvature weremeasured on the X-ray radiography. Other imaging features were alsoevaluated, including narrowing of disc height, hyperosteogeny of vertebral body, Luschka joint and soft tissue calcification and so on. The data wasanalyzed with the software of SPSS19.0, compared on independent-samplesT test or chi-square test. There was significant difference when p<0.05.Result:1. The incidence of cervical instability in youth group was higherthat in symptomatic group which was significantly different （p<0.05）.Unstable positions mainly distributed in C_4-5.The incidence of cervicalcurvature change in youth group and symptomatic group were89.3%,80.6%.There was not significant difference between the two groups （p>0.05）. Theincidence of other imaging features were low between the two groups,including narrowing of disc height, hyperosteogeny of vertebral body,Luschka joint and soft tissue calcification and so on. It showed that cervicalcurvature change is very common in a variety of cervical disease.2. The incidence of cervical instability in the youth groupand the middle-aged group were60.7%,76.4%, which was not significantdifferent between the two groups （p>0.05）. The average quantity of cervicalinstability in middle-aged group was more than that in youth group and therewere significant differences （p<0.05）. Unstable positions in the two groupsmainly distributed in C_4-5The incidence of cervicalcurvature change in the youth groupand the middle-agedgroup were89.3%,91.2%. There was not significant difference between thetwo groups （p>0.05）. The incidence of narrowing of disc height,hyperosteogeny of vertebral body, Luschka joint and soft tissue calcificationin the the middle-aged group is higher than that in the youth group.3. The main clinical manifestation in the youth group was dizziness,which was vertigo in the middle-aged group. Headache and the pain of neckand shoulder were widespread in the two groups, especially that theincidence of the pain of neck and shoulder in the youth group was higher thanthat in the middle-aged group. But there was not significant difference between the two groups （p>0.05）. The incidence of other manifestations in themiddle-aged group, including eye and ear dysfunction, autonomicdysfunction and nerve root irritation, is higher than that in the youth group,which was significantly different（p<0.05）. The symptoms of compressivemyelopathy were in the low incidence of the two groups.Conclusion:1. There is a close relationship between cervical instability and thepathogenesis of youth cervical vertigo. Unstable positions mainly distributedin C_4-5. The change of cervical curvature is the most important compensatorychange in the early time.2. The active control system dysfunction caused by the injury of themuscles around the neck and other soft tissue is the main reason ofcervical instability in the youth cervical vertigo. Degenerativechanges involve as secondary factors.3. Dizziness is the most common manifestation in the youth cervicalvertigo, which is often accompanied by some local symptoms, such asheadache, the pain or limited mobility of the neck and shoulder. Thesymptoms of stimulating never root and compressive myelopathy are notobvious.