Therapeutic Effect And Mechanism Of The Surgical Treatment For Cervical Vertigo With Cervical Spondylosis

[Objective] To investigate the therapeutic efficacy of surgical treatment for cervical vertigo with cervical spondylosis and factors that might interfere with therapeutic effect.[Methods] 621 patients who underwent cervical spinal surgery in our department from January 2004 to December 2013 were screened.35 of these patients satisfied the following inclusion criteria and were reviewed retrospectively:1) Presented with vertigo as a major symptom,2) Complicated with cervicospondylotic radiculopathy and/or myelopathy,3) Aural or neurovascular vertigo excluded,4) Conservative therapy failed and 5) Underwent surgery. Among the 35 patients 13 and 22 were male and female, respectively. The average age of the patients was 55.5 years old. Mean follow up period was 40.6 months. Pre-and-postoperative degree of vertigo was rated per the American Academy of Otolaryngology-Head and Neck Surgery Committee on Hearing and Equilibrium (AAO-HNS CHE) standard. Preoperative cervical curvature index (CCI) was evaluated on lateral cervical radiographs (Ishihara method). Preoperative slip distance and intervertebral angle, as well as the pre-and-postoperative cervical curvature (Cobb’s method) and cervical range of motion (CROM) were measured on lateral and flexion-extension cervical radiographs. Factors that might interfere with therapeutic effect were analyzed and possible mechanisms that caused vertigo were explored.[Results] Functional evaluation revealed a pre-and-post surgical average vertigo score of 4.3 and 1.6, respectively, thus documenting an average improvement of 2.7 points.29 of 35 (82.9%) patients had a satisfied recovery from cervical vertigo. Imaging study showed that among all 35 patients enrolled,33 presented suffered from cervical instability. Statistical analysis revealed that improvement in pre- and postoperative cervical curvature was positively associated with relief from vertigo (r=0.434, P<0.05). No association was established between post-surgical improvements in vertigo and pre-and-post surgical cervical curvature, CCI, CROM, level or number of involved segments.[Conclusions] Surgical treatment may relieve cervical vertigo accompanying cervical spondylosis. Cervical instability may have a relationship with cervical vertigo. Improvement in pre-and-postoperative cervical curvature has a positive correlation with the relief from vertigo.