Vertigo is a common clinical symptom and reason for hospital visits in middle-aged and elderly people. Cervical vertigo is a clinical syndrome mainly caused by vertigo and balance disorders of cervical origin, and is one of the more common causes of vertigo in the elderly. With the change of people’s living habits and working environment, the incidence of cervical vertigo tends to increase, and research shows that the age of onset of cervical vertigo patients is decreasing. Clinical manifestations 1. Patients have dizziness, swaying and floating sensations, which occur mostly when the neck is in motion; sometimes they have variable vertigo when sitting up or lying down; 2. Patients have stiffness and swelling of the neck, which occur mostly in the morning; 3. 4. When changing the position, especially when twisting the head, the vertigo can be aggravated, and in serious cases, sudden collapse can occur, but it is usually not accompanied by consciousness impairment. The pathogenesis of cervical vertigo is very complicated, and scholars at home and abroad have done a lot of research on it, but it is still unclear. Recent studies have shown that the pathogenesis of cervical vertigo is multifactorial and is related to sympathetic factors, cervical degeneration and instability, blood viscosity and vascular factors, which finally lead to insufficient blood supply to the vertebral artery. 1. Insufficient blood supply to the vertebral a basilar artery: vertebral. The basilar artery system mainly supplies blood to the brainstem, cerebellum, lower temporal lobe and medial occipital lobe of the lateral cortex. When congenital vertebral artery is narrowed or occluded, it can cause congenital cervical vertigo. Arthrosynovial joint and hook vertebral joint hyperplasia can easily cause compression of the vertebral artery via the transverse foramen, narrowing the vertebral artery and causing vertigo. 2. Sympathetic factors: Sympathetic factors manifest as direct or indirect stimulation of cervical sympathetic plexus, which causes spasm of vertebral artery and insufficient blood supply of vertebral basilar artery, resulting in vertigo symptoms. This is the result of stimulated excitation of sympathetic nerve and the release of norepinephrine from its endings, which acts on the receptors and causes vasoconstriction. It is often caused by the stimulation of sympathetic nerves by factors such as degenerative changes of the cervical spine such as osteophytes of the hook vertebral joint and hook synovial joint. 3, cervical degeneration: cervical degeneration, due to loss of intervertebral disc water, narrowing of the intervertebral space, protrusion of the intervertebral disc, which in turn causes disorder, hypertrophy, hyperplasia of the intervertebral small joints thus triggering cervical instability. It can compress the vertebral artery and stimulate the sympathetic nerve, leading to spasm of the vertebral artery and its branches, aggravating the symptoms of cerebral ischemia. 4, cervical spine fracture: vertigo is also a more common clinical symptom when cervical spine injury, the cause of which is mostly direct trauma to the vertebral artery . Cervical spine injury when cervical spine injury between adjacent transverse foramina is overstretched and tension increases, resulting in primary contusion of the inner wall of the blood vessel, followed by thrombus formation in the luminal wall and eventually the formation of complete embolism . The result is insufficient blood supply to the brain, causing vertigo. There are many factors that cause vertigo, and cervical vertigo should be distinguished from vertigo caused by neurosis, ophthalmogenic vertigo and intracranial neurovascular lesions. The main points of cervical vertigo diagnosis are as follows: 1. Clinical symptoms as mentioned above and a long medical history; 2. Cervical spine X-ray can show changes in the physiological curvature of cervical spine, intervertebral disc changes, vertebral osteophytes, transverse foraminal changes, etc.; 3. 4, for intervertebral disc degeneration, cervical medullary compression degeneration, cervical soft tissue lesions better than CT, magnetic resonance angiography (MRA) can clearly show the vertebral artery involvement, such as vertebral artery compression, tortuosity, deformity and other changes.