Vertigo is a motion hallucination in which the patient feels that surrounding objects or himself are rotating, lifting and tilting. Cervical vertigo refers to vertigo caused by insufficient blood supply to the vertebral artery due to cervical lesions and often has the following characteristics: dizziness or vertigo accompanied by neck pain; dizziness or vertigo mostly occurs after neck activities; positive cervical torsion test in some patients; abnormal neck imaging, such as cervical frame retroflexion, vertebral instability and disc herniation; history of neck trauma; and other causes are ruled out. Usually associated with cervical spondylosis, but not necessarily caused exclusively by cervical spondylosis.
Etiology
The etiology is not clear, but may be due to compression of vertebral artery by cervical spondylosis, spasm of vertebral artery caused by stimulation of sympathetic nerve in the neck, etc. The main types of cervical spondylosis related to cervical vertigo are vertebral artery type and sympathetic type. Cervical vertigo due to sympathetic cervical spondylosis is caused by vasoconstriction of the vertebral basilar artery due to sympathetic nerve excitation, which causes some clinical symptoms of inadequate blood supply to the posterior circulation, such as vertigo, nausea and vomiting. In contrast, cervical vertigo caused by vertebral artery type cervical spondylosis is due to compression of the vertebral artery, which in turn causes inadequate blood supply.
Examination
1.X-ray can show degeneration of cervical vertebrae, intervertebral discs, hooked joints and calcification of collateral ligaments, and changes such as straightening of cervical physiological curvature.
2, cerebral ultrasound can be seen in the vertebral basilar artery blood flow reduction.
Differentiation
1.Onset of vertigo is mostly over 40 years old.
2. The onset of vertigo is often related to the change of neck position. When the neck is tilted back and rotated, vertigo or nausea can be induced.
3.It can be accompanied by neurogenic symptoms.
4.Sudden onset of vertigo often occurs when getting up or turning head suddenly, often accompanied by horizontal nystagmus.
5.Cervical spine examination shows that the movement of the neck is restricted, the spine of the affected vertebra is distorted, and there is pressure pain beside the vertebra, and the distortion of the spine of cervical 2 is common because the vertebral artery enters the transverse foramen and rises vertically, and multiple bends of the vertebral artery occur in this section from the 2nd cervical vertebra to before entering the greater occipital foramen, and the obstruction of the blood flow of the vertebral artery also occurs here.
6, cerebral hemogram, occipital breast leads, insufficient blood supply to the vertebrobasilar artery, positive neck twist test.
7, cervical spine X-ray plain film, front and side film, left and right oblique and open position film show that the cervical spine physiological curve is straightened, reverted, angled or interrupted, osteophytes, posterior cervical nodes are upturned, and the dentate is unequal in distance from both sides of the block.
Treatment
1.Massage the soft tissues of the neck.
2.Cervical spine traction.
For the elderly, narrowing of the vertebral space and obvious osteophytes can do cervical traction treatment. 10 times for a course of treatment. According to the needs of the condition, traction can be continued at intervals of 3 to 5 days.
3.Physiotherapy
Relieve muscle spasm and eliminate local sterile inflammation. Commonly used ultrashort wave, infrared ray, etc.
4.Closure
Available 0.5% procaine solution, prednisone cervical posterior joint capsule closure, once a week, 3 times for a course of treatment.
5.Drugs
In the acute stage, use vasodilators, such as betahistine (pethidine) sodium chloride injection 500 ml plus triclopidine (vincristine) static point, 10 days a course of treatment, with vitamin drugs such as vitamin B1, B6, etc. orally.
6.Surgical treatment
After various conservative treatment does not work, serious osteophytes, cervical spinal stenosis, etc. need surgery.