Cervical vertigo 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. “My neck hurts, and my head is always dizzy, so I can’t live normally!” Ms. Liu, who is over 30 years old, has been feeling dizzy lately, and she has been feeling neck and shoulder pains, and her vertigo increases when she moves her neck. She didn’t pay much attention to it at first and didn’t see a doctor until a few days ago when she felt nauseous and vomited for no reason, so she immediately took time off work to come to the hospital. Cervical vertigo is more common in patients over 40 years old and in women, and its incidence is increasing year by year. The incidence of cervical vertigo is increasing year by year, and the number of patients is getting younger and younger, with many patients in their 20s and 30s.
1. Pathogenesis
The pathogenesis of cervical vertigo is generally believed to be a vertigo syndrome caused by insufficient blood supply to the vertebral basilar artery (VBI) due to compression or (and) stimulation of the extracranial segment of the vertebral artery by a cervical lesion.
Long hours of ambulation or keeping the neck in the same position for too long, the neck is usually severely involved, causing cervical degeneration and segmental instability, which stimulates or even compresses the vertebral artery and causes insufficient blood supply. On the other hand, the sympathetic nerve fibers rich in the surface of the vertebral artery are stimulated, which can also cause inadequate blood supply to the posterior circulation. Sedentary office population, and often focus on playing cell phones, keep the same posture for too long, the muscle groups around the cervical spine easily fatigue, the vertebral artery is compressed.
2.Characteristics: vertigo when moving around the neck
Cervical vertigo usually occurs in middle-aged and old-aged patients, but there is a trend of youthfulness, and the number of young patients in their twenties and thirties is increasing. Patients with cervical vertigo usually have symptoms of neck and shoulder pain, or even a feeling of “spinning” to varying degrees, and in severe cases, nausea and vomiting. The most distinctive feature of cervical dizziness is that it is easy to have a sudden attack when the head is tilted back excessively or when doing rotational movements, or to intensify the dizziness, and the symptoms may disappear when the tilting is stopped.
In case of dizziness caused by organic diseases, it is advisable to consult a spine surgeon to relieve the symptoms through treatment.
3. Diagnosis: X-ray of cervical spine changes
In terms of diagnosis, cervical vertigo is often underdiagnosed or misdiagnosed, and is easily confused with dizziness caused by hypertension, diabetes, neurosis and other diseases. Diagnosis is mainly based on combining clinical symptoms with imaging. Initial observation of segmental stability and changes in the hook vertebral joints by cervical spine X-ray can suggest the existence of vertebral artery type cervical spondylosis and confirm the diagnosis of cervical vertigo, and X-ray is also a relatively easy and less expensive method.
The following points are related to cervical vertigo.
(1) Neck pain is closely related to vertigo symptoms, and some patients have positive neck torsion test.
(2) History of previous neck trauma or disease, and clear cervical spondylosis on neck imaging such as cervical spine film, CT, MRI.
(3) Exclude other causes of dizziness.
People rarely associate dizziness with cervical spondylosis, and even if they have obvious neck and shoulder pain, they will take many detours before coming to a spine specialist.
4.Conservative treatment can relieve
After the diagnosis of cervical vertigo, patients do not need to panic. Generally, symptomatic treatment by medication, together with physical therapy, etc. can relieve the symptoms of dizziness. Non-surgical treatment, such as neck massage, is the basic treatment of the disease, which is mainly based on changing the blood circulation itself and relieving the symptoms by releasing the spasm of neck muscles, eliminating local inflammation and edema, reducing the excitability of nerves and eliminating the irritating factors of vertebral artery.
For those whose quality of life is seriously affected by unsatisfactory long-term treatment, surgical treatment can also be considered. In addition to vasodilators, sympathetic nerve stabilizing drugs and traction therapy are also used for sympathetic cervical spondylosis. Specially reminded that the cervical spine “traction” treatment should be used with caution and under the guidance of a doctor.
5.How to prevent dizziness caused by cervical spondylosis
When working, get up every half hour, turn your head and neck, and move around for a while. The air conditioner should not blow against the neck, so you can prepare a jacket with a collar in the office and pay attention to the warmth of the neck and shoulders. In addition, pay attention to the sleeping position, the best to lie flat. Lying on your side or sleeping on your stomach and pressing your arms under your head will increase the burden on your cervical spine. The pillow should be narrower, can rest under the neck, to a fist height is better. When sleeping, the head is slightly tilted back somewhat to ensure a slight curvature of the cervical spine.
1.Confront the disease and build confidence
Have a correct understanding of the disease and establish confidence in overcoming the disease. Cervical spondylosis has a long course, and the degeneration of the intervertebral disc, the growth of bone spurs, ligament calcification, etc. are related to ageing and aging of the body. The disease is often recurrent, and the symptoms may be heavier during the attack, affecting daily life and rest. Therefore, on the one hand, we must eliminate the fear of pessimism, and on the other hand, we must avoid the mentality of getting by.
2. Pay attention to rest
Bed rest has an important role in relaxing the neck muscles, reducing muscle spasm and the pressure of the head weight on the intervertebral disc, as well as eliminating tissue pressure edema. However, bed rest should not be too long to avoid changes such as muscle atrophy, tissue adhesions and joint adhesions, which hinder the recovery of cervical spondylosis.
3, pay attention to the maintenance of the body
The human body is like a complex machine that needs to be maintained from time to time. Especially the cervical spine, should try to avoid unnecessary injury. Whether it is sleep, rest, study and work, and even some daily movements, we must maintain good habits, always forget the protection of the cervical spine, while strengthening the exercise of the cervical muscle.
4, do not rush to the doctor
The treatment of cervical spondylosis is divided into surgical and non-surgical treatment. The vast majority of patients can be relieved or even cured by non-surgical treatment. But each treatment method has its own unique operation, role and indications, and requires the guidance of a specialist physician, and there is a certain course of treatment. It is important not to seek medical advice in a hurry, change treatment methods frequently or use multiple methods in a haphazard manner, which will not only fail to achieve therapeutic effect but also aggravate the disease.