Mechanoreceptors in Diseased Cervical Intervertebral Disc and Vertigo

Yang, Luting; Yang, Cheng; Pang, Xiaodong; Li, Duanming; Yang, Hong; Zhang, Xinwu; Yang, Yi; Peng, Baogan

doi:10.1097/brs.0000000000001801

Cited by 53 publications

(65 citation statements)

References 47 publications

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“…Recent studies have identified possible objective measures of neck contribution in those diagnosed with cervical vertigo . When compared to healthy control subjects, Johnston et al found that a prolonged reduction in vestibular response to head movement (ie, VOR) when patients attempted to acquire visual targets with cervical soft tissue disorders and normal neuro‐otologic examinations .…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have identified possible objective measures of neck contribution in those diagnosed with cervical vertigo. 17,30,31 When compared to healthy control subjects, Johnston et al found that a prolonged reduction in vestibular response to head movement (ie, VOR) when patients attempted to acquire visual targets with cervical soft tissue disorders and normal neuro-otologic examinations. 31 Their results suggest that neck limitations, due to pain or stiffness, manifest an exaggerated proprioceptive response and subsequent disproportionate VOR suppression, which translates into subjective symptoms of dizziness and imbalance.…”

Section: Discussionmentioning

confidence: 99%

“…The main clinical problem in diagnosing cervical vertigo is that symptoms of subjects who have both neck disorders and dizziness may overlap with other entities. In other words, it is difficult to differentiate between the chance coincidence of arthritis of the neck and dizziness, from the situation where arthritis of the neck causes dizziness . Additionally, clinicians find similar symptomatology is associated with psychogenic dizziness as well as migraine headache …”

Section: Introductionmentioning

confidence: 99%

“…In other words, it is difficult to differentiate between the chance coincidence of arthritis of the neck and dizziness, from the situation where arthritis of the neck causes dizziness. 16,17 Additionally, clinicians find similar symptomatology is associated with psychogenic dizziness as well as migraine headache. [18][19][20] To test the hypothesis that a set of distinct symptoms can characterize cervical vertigo, we administered a questionnaire to subjects with cervical vertigo, vestibular migraine and those with vestibular vertigo.…”

Section: Introductionmentioning

confidence: 99%

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Symptoms in cervical vertigo

Thompson‐Harvey

Hain

2018

Laryngoscope Investig Oto

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Objective To use a unique, 41‐question survey to identify patient features distinguishing cervical vertigo from vestibular causes of vertigo and vestibular migraine. Methods In this study, a unique, 41‐question survey was administered to 48 patients diagnosed with cervical vertigo (n = 16), migraine (n = 16), and vestibular vertigo (eg, unilateral vestibular paresis, Meniere's disease) (n = 16) to test the hypothesis that a set of distinct symptoms can characterize cervical vertigo. Responses between the three diagnostic groups were compared to identify questions which differentiated patients based on their symptoms. Results Eight questions were successful in differentiating vestibular vertigo from migraine and cervical vertigo. Symptoms endorsed by subjects with cervical vertigo overlapped substantially with subjects with well‐established vestibular disturbances as well as symptoms of subjects with migraine. Twenty‐seven percent of cervical vertigo subjects reported having true vertigo, 50% having headache, and 94% having neck pain. Conclusion Lacking knowledge of neck disturbance, the symptoms we elicited in our questionnaire suggest that cervical vertigo subjects may resemble migraine subjects who also have evidence of neck injury. Whether or not subjects with “cervical vertigo” also overlap with other diagnoses defined by a combination of symptoms and exclusion of objective findings such as chronic subjective dizziness and other variants of psychogenic dizziness remain to be established. Level of Evidence IV

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Symptoms in cervical vertigo

Thompson‐Harvey

Hain

2018

Laryngoscope Investig Oto

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“…However, there is only limited data about the prevalence of CV. The study by Karlberg et al (9) showed that vertigo and subjective balance disturbances are common complaints in the patients with cervical root compression (10). Another study showed that vertigo was present in 50% of patients with cervical spondylosis (10-13), while cervical spondylosis was the cause of dizziness in 65% of elderly patients in another study (6).…”

mentioning

confidence: 95%

Response to Cervical Medial Branch Blocks In Patients with Cervicogenic Vertigo

et al. 2018

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Background: Among the various causes of vertigo, the so-called cervicogenic vertigo (CV) has been the most controversial. However, perturbations of proprioceptive signals and abnormal activity of the cervical afferents can induce vertigo. Medial branch blocks (MBBs) are a diagnostic tool designed to test whether a patient’s neck pain is mediated by one or more of the medial branches of the dorsal rami of the spinal nerve. It is unknown whether MBBs are also suitable for testing symptoms other than pain. Objectives: The purpose of this study was to test whether MBBs of the cervical spine can be used as a diagnostic tool to identify patients with CV. Study Design: A retrospective practice audit (clinical observation). Setting: An interventional pain management and spine practice. Methods: An electronic medical record system was used to identify patients in a single spine center. Included were consecutive patients with neck pain and vertigo, who had received cervical MBBs in a period from July 2001 to April 2016. The patients were tested with a MBB of about 1 mL of bupivacaine (0.25%) and 20 mg triamcinolone. Injections were performed with fluoroscopic visualization using established techniques in 2 or 3 levels on one or both sides. Vertigo was analyzed through the global clinical impression of the patient (i.e., “gone,” “better,” “the same,” or “worse”). Results: One-hundred seventy-eight patients met the inclusion criteria. One-hundred eleven patients (62.4%) experienced a significant improvement of the vertigo. In 47 patients (26.4%), no information about the vertigo was available at follow-up; these patients were assumed to have no improvement (worst-case scenario). Hence, altogether 67 patients (37.6%) had a negative result. The median relief of the vertigo was 2 months. Differences in age, gender, level of treatment, or pain duration between patients with relief of the vertigo and without relief were not found. Nine patients with a whiplash injury in their medical history were also tested. They experienced a lower success rate and had longer duration of pain before the treatment; however, these differences are not statistically significant. Limitations: It was the primary intention to treat neck pain; the assessment of vertigo was an additional aim. Therefore, the history taken and the clinical examination were not targeted specifically to vertigo. A placebo effect cannot be excluded. Further studies with the primary focus on CV are necessary to prove the significance of MBBs. Conclusions: This is the first study to demonstrate that MBBs of the cervical spine can be a useful tool for the diagnosis of CV, because they temporarily block cervical afferents. In 63.4% of patients with neck pain and suspected CV, the vertigo was significantly improved. Further placebo-controlled studies with the primary intention on CV are necessary to prove the significance of MBBs. Key words: Cervicogenic vertigo, medial branch block, facet joint, zygapophysial joint, neck pain, differential diagnosis

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Association of Cervical Spondylosis With Peripheral Vertigo: A Case–Control Study

et al. 2020

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Objectives/Hypothesis This study aimed to assess the association of prior cervical spondylosis (CS) with peripheral vertigo. Study Design Case–control study. Methods Data were retrieved from the Taiwan Longitudinal Health Insurance Database. A total of 2,570 patients who were newly diagnosed with peripheral vertigo were identified. We compared them with a 3:1 ratio of propensity score–matched patients, 7,710 comparison patients from the same dataset. We performed multivariate logistic regressions to estimate the odds ratio for prior CS occurrence among peripheral vertigo patients versus controls. Results Of 10,280 sample patients, 1,739 (16.92%) patients had CS prior to the index date. A significant difference in prior CS between peripheral vertigo patients and controls (19.49% vs. 16.06%, P < .001) was observed. Logistic regression analysis shows that the odds of prior CS was 1.285 for peripheral vertigo patients versus controls (95% confidence interval [CI]: 1.143‐1.446) after adjusting for age, sex, urbanization level, monthly income, geographic region, hyperlipidemia, diabetes, coronary heart disease, hypertension, and asthma. Prior CS with myelopathy was not associated with peripheral vertigo. Stratified analysis by age showed that the odds of CS were highest among patients with peripheral vertigo in the 45‐ to 64‐year‐old age group (1.442, 95% CI: 1.215‐1.712). Conclusions CS is associated with subsequent peripheral vertigo in the Taiwan population, with higher risk among those aged 45 to 64 years. Level of Evidence 2b Laryngoscope, 131:E625–E630, 2021

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Mechanoreceptors in Diseased Cervical Intervertebral Disc and Vertigo

Abstract: 1.

Cited by 53 publications

References 47 publications

Symptoms in cervical vertigo

Symptoms in cervical vertigo

Response to Cervical Medial Branch Blocks In Patients with Cervicogenic Vertigo

Association of Cervical Spondylosis With Peripheral Vertigo: A Case–Control Study

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