Cervical Instability Is An Important Factor In The Pathogenesis Of Cervical Vertigo

Background:Cervical vertigo consists of various symptoms which provoked by autonomic nerve functional disorder due to cervical degenerative changes. It is commonly seen in elder people when turning head or changing posture, and females more than males.The patient mainly complains of vertigo and some accompanying symptoms such as nausea, vomiting, neck pain, shoulder pain, tinnitus, visual disturbances, sweating, palpitations, and numbness in upper extremity. The vertigo can last from minutes to days and can be relieved by resting in bed. Recently, with the popularity of computers, the changed lifestyle leads to an increasing number of patients with cervical vertigo, and the age of the patients tends to be younger. Currently the diagnosis of vertigo involves ENT, neurology, ophthalmology, cardiology, orthopedics and other fields. Vertigo as a chief complaint, patients can have different severe symptoms but with less positive physical. The symptoms can have various combinations and there is no particular adjuvant ways to help diagnose it.Since it is difficult to establish an effective animal model for vertigo, it’s one of the many diseases that are difficult to diagnose and treat. In addition, the causes, pathogenesis, diagnosis and treatment are still under exploration, therefore whether it can be seen as a disease remains controversial. The aim of the study was to evaluate the efficacy and safety of the cervical operation by observing the long-term improvements and symptoms of the patients who were followed up. So as to further explore the causes of the cervical vertigo and provide clinical references.Objective:The study aims to assess the curative effect and to find out the pathogenesis of cervical vertigo through long term postoperative fellow-up observations of the patients with severe cervical vertigo.Methods:Fellow-up is done for patients who had operation due to severe cervical vertigo in China-Japan friendship hospital from1997to2009:1. Explore the occurrence pattern of cervical vertigo through statistical analysis of the preoperative information for the patients.2:Assess the curative effect of the surgical operation through postoperative fellow-up observations.3:Observe whether there are internal fixation failures and adjacent vertebral degenerative changes through data imaging.4:Analyze the curative effect and satisfaction of the patients who received the cervical vertigo surgical operation. Results:1. Follow-ups for severe cervical vertigo patients is43cases in total,19cases were via the phone,24cases were from the clinic, Male15cases, Female28cases, age of the patient were from34to80, average age was58.2±1.7, average course of the disease was3years and a month, the shortest follow-up time was5years and4months, and the longest was16years and9months, the average follow-up time was8year and11months.26cases were diagnosed as simple cervical vertigo, among the rest17cases,12cases companied with cord symptom,6cases companied with radicular symptom,1cases companied with both symptom.2.37cases of anterior cervical vertebral body decompression fusion and internal fixation, and6cases of cervical posterior vertebral canal decompression. Extradural blocking was taken preoperatively in26cases, vertigo symptoms were obviously released or disappeared.13cases with one spinal segment unstable,25cases with2spinal segments unstable,5cases with3spinal segments unstable. C3/4unstable:16cases; C4/5:28cases; C5/6:27cases; C6/7:6cases.3.40cases with vertigo totally eliminated(2patients died, before their death, vertigo symptoms were eliminated and no recurrence), and2cases still suffering numbness of fingers,2cases suffering discomfort in the neck,3cases suffering dizziness. In the3cases, one patient is74, diagnosed as cervicovestibular with cervical spondylotic myelopathy. Vertigo symptom disappeared after operation.8years later, after the cerebral infarction, accidental light dizziness and inconvenience in walking remained. The other patient’s dizziness was eliminated. Cerebral infarction happened3years after operation, dizziness happened accidentally.4. VAS assessment:2mild cases, no moderate and severe cases.5. Curative effect assessment: excellent45cases,93.0%; good2cases,7.0%. Good rate100%.6. Imaging data:25cases with X ray, no instability for the fusion and no looseness for the internal fixation.Conclusions:It’s safe and satisfactory for the patients suffering from severe cervical vertigo to receive fusion and internal fixation for the instable segment.