Causes and treatment of cervical spondylosis and vertigo

  Vertigo caused by cervical spondylosis refers to vertigo caused by organic or functional changes in the cervical spine and related soft tissues (joint capsule, ligaments, nerves, blood vessels, muscles, etc.), also known as Barre-Lieon syndrome.  Clinical manifestations: 1. Vertigo: it can be motion illusion vertigo, or dizziness, swaying, floating sensation, mostly occurring during neck movement; sometimes presenting varicose vertigo when sitting up or lying down, and a few may present cochlear symptoms.  2. Neck and/or occipital pain: mostly occurs in the morning when waking up.  3. Cervical nerve root compression symptoms: including abnormal sensation and weakness in the affected shoulder and upper limbs, and dislodging of holding objects.  4. There may be foreign body sensation in the throat and visual symptoms (such as blurring).  Etiology: The exact cause is unknown, and the answer is mostly found in the following aspects: 1. Vascular factors: mainly vertebral artery compression or vertebral artery spasm. Small joint hyperplasia, bone superfluous formation, etc. can cause mechanical compression of the blood vessels, narrowing or occlusion occurs. Spasm of the vertebral artery is often caused by stimulation of the cervical sympathetic nerve. Both of these conditions have a prerequisite that the head and neck must be turned to a certain position so that the vertebral artery is compressed or the sympathetic nerve is stimulated.  2. Abnormal nerve impulse transmission: The soft tissue of the cervical segment, especially the upper cervical segment, has increased intra-tissue pressure due to chronic injury, which reflexively stimulates the nerve branches in it, and because the nerves in the brain communicate with the nerves in the soft tissue of the cervical segment, they also stimulate the vertigo centers such as the anterior tine nucleus and the red nucleus of the brain and the vertigo appears.  3.Cervical spinal cord compression: it may involve the upward or downward conduction tract of the spinal cord.  4. Cerebrospinal fluid leakage: It has been observed that vertigo is associated with hyperextension and hyperflexion injury to the cervical spine, nerve root cuff tear, and cerebrospinal fluid leakage.  Treatment: 1. Etiological treatment: The main treatment is cervical spine surgery, including cervical plaster fixation, cervical traction and surgery if necessary.  2. To improve the microcirculation in the inner ear by targeting the impaired blood supply to the inner ear: commonly used drugs include dibazol, nicotinic acid, pethidine, flunarizine, compound Chuanxiongzin, compound Danshen tablets, Ducoxib, etc. To reduce blood viscosity, dipyridamole, aspirin, etc. are available.  3, vestibular sedatives: such as diazepam, promethazine, diphenhydramine, etc.