The Inside Story of Cervical Vertigo

  ”Cervical vertigo” is called “Xiang paralysis” in Chinese medicine, which means paralysis and obstruction. Clinical symptoms include dizziness, nausea, vomiting, tinnitus, blurred vision, etc. The most prominent feature is postural vertigo, i.e., vertigo is aggravated when changing position, especially when twisting the head, and in severe cases, sudden collapse may occur, but it is usually not accompanied by impaired consciousness. In addition, the vertebral artery and sympathetic nerve are parallel, so vertebral artery cervical spondylosis is often accompanied by some sympathetic symptoms, such as pseudo-angina, myocardial ischemia, sweat gland secretion disorder, partial limb or half body sweating or less sweating, and digestive dysfunction. Cervical vertigo is generally not difficult to diagnose. The diagnosis of cervical vertigo is not difficult based on the clinical characteristics of its symptoms, supplemented by X-ray, CT film and cranial ultrasound.  One is the mechanical compression of the pushing vein by the bone spur, resulting in stenosis or occlusion, which is more likely to occur when the pushing vein itself is diseased; the other is the stimulation of the cervical sympathetic nerve, causing spasm of the pushing vein. In both cases, there is a prerequisite that the head and neck must be turned to a position that allows the pushing vein to be compressed or the sympathetic nerves to be stimulated. In short, the vertigo attack is clearly related to the position of the head and is called positional vertigo.  Some patients may have a history of sudden collapse, mostly when they hear shouting behind them while walking, and when they look back, they suddenly fall to the ground with weakness in their lower limbs, and after they fall to the ground, their head position returns and the symptoms disappear, and they can get up immediately. Cervical vertigo is characterized by positional vertigo of the head and neck, which occurs when the head and neck are turned or bent sideways to a specific position, and the symptoms disappear after the position is restored. After 2-3 episodes, the patient is conscious of this and is very alert to avoid this specific position. However, when the pushing pulse type of cervical spondylosis has the pushing pulse sympathetic plexus involved in it, or when it occurs mixed with sympathetic cervical spondylosis, the vertigo symptoms can become atypical, unusually complex and difficult to distinguish.  The traditional concept of “cervical vertigo” is that vertigo occurs when the soft tissues of the cervical segment, especially the upper cervical segment, are chronically damaged, causing increased pressure in the tissues and reflexively stimulating the nerve branches therein, and because the nerves in the brain communicate with the nerves in the soft tissues of the cervical segment, they also stimulate the vertigo centers of the brain, such as the anterior tine nucleus and the red nucleus. However, most of the soft tissue damage in the cervical segment is secondary to soft tissue damage in the lumbar, hip and leg area, so soft tissue damage in the neck is a secondary factor. The increased pressure in the soft tissues of the neck is also the result of spasmodic pulling of the sacrospinous muscles secondary to the stimulation of the sensory nerve endings in the damaged soft tissues by aseptic inflammation. In some patients, the stimulation of the nerve branches in the soft tissues of the neck is actually aseptic inflammation, but in patients with no neck and head pain but only vertigo, the soft tissues of the neck have not yet formed aseptic inflammation with secondary damage, and the increased pressure in the soft tissues of the neck is only due to the pull of the spasm of the soft tissues of the lower part of the sacrospinous muscle; there is also the spasm of the soft tissues of the lateral side of the neck with damage lesions that also act on the soft tissues of the neck. In patients with vertigo accompanied by headache, the pathological basis of secondary damage to the soft tissues of the neck has been formed as a result of aseptic inflammation. Only when the nature of these diseases is clarified, it is no longer difficult to completely cure “cervical vertigo”.  The main symptoms of “vertebral artery type cervical spondylosis” are: headache, vertigo and visual disturbance caused by ischemia of the posterior cerebral artery, which are manifested by episodes of reduced visual acuity, flashes of light in front of the eyes, dark spots, visual field defects, ventral vision, hallucinations, etc. Headache is caused by insufficient blood supply to the basal vertebral artery. The headache is caused by insufficient blood supply to the vertebral basal motive force, as well as many Lewy brain signs. Vertigo is the most common symptom of the disease, which can be rotational in nature, i.e., hallucinations of rotation of oneself or the surrounding scenery in a certain direction, or general vertigo, which is manifested by body swaying and unstable standing and walking or ground movement, tilting, sinking, etc., and is often induced when changing position. Soft tissue surgery has found in a large number of clinical practices that these related symptoms can be seen in the head, neck, shoulder, lumbosacral, hip and leg extravertebral soft tissue damage. Furthermore, since most patients have persistent vertigo, it is not caused by the vertebral artery, but by the autoregulation of the wills’ ring, the brain will open many anastomosing branches to supply the cerebral flow to a balanced state. In addition, many people with vertigo and headache caused by inadequate vertebral artery blood supply are still suffering from inadequate vertebral artery blood supply after their symptoms are completely eliminated by strong stimulation massage or silver needle treatment, and there is also inadequate vertebral artery blood supply in healthy people without headache and dizziness. There are also scholars who believe that cervical spondylosis is due to small joint disorders, but soft tissue surgery never contends with the treatment of displaced small joints, and after using silver needle to cure soft tissue damage lesions, small joint disorders disappear through their own regulation, which proves that small joint disorders are all secondary manifestations of spasm of deep spinal multifidus and piriformis muscles, and that small joint disorders cause cervical spondylosis is all a cause-and-effect inversion of understanding. Therefore, vertebral artery cervical spondylosis is actually a manifestation of soft tissue damage in the lumbar and hip thigh roots or the head, neck and shoulders, and patients with vertebral artery cervical spondylosis cured by various traditional methods are actually cured of soft tissue lesions outside the vertebral canal and the clinical effect is produced.