[Moxibustion at Baihui combined with acupuncture for cervical vertigo: a Meta-analysis and trial sequential analysis].

OBJECTIVE: To evaluate the efficacy and safety of moxibustion at Baihui (CV20) combined with acupuncture in treatment of cervical vertigo. METHODS: From the databases, such as CNKI, VIP, WanFang, CBM, PubMed, Cochrane Library and Embase, the studies of randomized controlled trials (RCTs) on moxibustion at CV20 combined with acupuncture for cervical vertigo were searched from inception to September 15th, 2021. The Cochrane risk of bias assessment tool was utilized to evaluate the quality of the included literature. Using RevMan5.3, Stata12.0 and TSA0.9.5.0 10 Beta software, the Meta-analysis and trial sequential analysis (TSA) were performed. RESULTS: Seventeen RCTs with 1 232 patients were included. Meta-analysis showed that in the trial group (moxibustion at CV20 combined with acupuncture), the total effective rate (RR=1.17, 95%CI［1.12, 1.22］, P<0.000 1), the curative and remarkably-effective rate (RR＝1.28，95%CI［1.20，1.36］，P<0.000 1) and the score of cervical vertigo (WMD=2.88, 95%CI［1.87, 3.89］, P<0.000 1) were all better when compared with the control group (simple acupuncture or electroacupuncture group). The results of trial sequential analysis indicated that for the cumulative Z-score of each RCT, the Z-curve crossed the conventional test boundary and TSA boundary, which further confirmed the clinical efficacy of moxibustion at CV20 combined with acupuncture on cervical vertigo. CONCLUSION: The clinical efficacy of moxibustion at CV20 combined with acupuncture is determined in treatment of cervical vertigo.

Effect of Guizhi Gegentang on Hemodynamics and Vascular Endothelial Function in Cervical Vertigo / 中国实验方剂学杂志

ObjectiveTo evaluate the therapeutic effect of Guizhi Gegentang on cervical vertigo and its impact on hemodynamics and vascular endothelial function. MethodA total of 144 patients with cervical vertigo treated from April 2019 to June 2022 were included in the study and randomly divided into a control group and an observation group， with 72 patients in each group. During the study， three patients dropped out from the observation group and two patients from the control group. The control group received conventional treatment （oral betahistine mesylate tablets）， while the observation group received conventional treatment combined with Guizhi Gegentang. The clinical efficacy， changes in the frequency and duration of dizziness attacks per month before and after treatment， changes in symptoms and functional evaluation scores of cervical vertigo assessed by the European Scale for Cervical Vertigo （ESCV）， changes in the average blood flow velocity of the left vertebral artery， right vertebral artery， and basilar artery， changes in indicators such as endothelin-1 （ET-1）， neuropeptide Y （NPY）， calcitonin gene-related peptide （CGRP）， changes in the Neck Disability Index （NDI） score， changes in the Functional Assessment of Cancer Therapy-General （FACT-G） score， and adverse reactions were observed and compared between the two groups. ResultThe total effective rate in the observation group was 95.65% （66/69）， significantly higher than 84.29% （59/70） in the control group （χ2=4.957， P<0.05）. Before treatment， there were no significant differences in the frequency and duration of dizziness attacks per month， ESCV scores， average blood flow velocity of the left vertebral artery， right vertebral artery， and basilar artery， levels of ET-1， NPY， CGRP， NDI score， and FACT-G score between the two groups. After treatment， compared with the baseline within each group， there were improvements in the frequency and duration of dizziness attacks per month， ESCV scores， average blood flow velocity of the left vertebral artery， right vertebral artery， and basilar artery， levels of ET-1， NPY， CGRP， NDI score， and FACT-G score in both groups （P<0.05， P<0.01）. Compared with the control group， the observation group showed better improvements in the frequency and duration of dizziness attacks per month， ESCV score， average blood flow velocity of the left vertebral artery， right vertebral artery， and basilar artery， levels of ET-1， NPY， CGRP， NDI score， and FACT-G score （P<0.05， P<0.01）. During the study period， one case of nausea occurred in the control group， and one case of dizziness occurred in the observation group. There was no statistically significant difference in the incidence of adverse reactions between the two groups. ConclusionGuizhi Gegentang can improve the therapeutic effect of cervical vertigo， effectively improve patients' hemodynamics and vascular endothelial function， and enhance their quality of life with few adverse reactions. It is worth applying in clinical practice.

[Cervicogenic vertigo]. / Tservikogennoe golovokruzhenie.

The prevalence of cervical dizziness, still not recognized by the entire medical community, not only does not become less frequent, but even increases today. This phenomenon is facilitated by the widespread computerization of our lives and, in particular, the strain on the neck when working with portable electronic equipment. Despite the fact that criteria that reliably confirming the association of dizziness with cervical pathology have not yet been defined, experimental and clinical evidence of such an association continues to accumulate. This review presents data from studies of the last few years on cervical pathology as a causative factor in some types of dizziness and vertigo. To date, the following variants of cervical vertigo are distinguished: Barre-Lieu syndrome, rotational vertebral artery syndrome, proprioceptive cervical vertigo, migraine-associated cervical vertigo. The paper considers the features of all four cervical vertigo types, as well as methods for diagnosing and the first randomized trials on the treatment of dizziness associated with the pathology of neck structures. The results of own observations of similar cases (diagnosis and treatment) are described; as well as principles of differential diagnosis of some conditions manifested by headache and dizziness in patients with various types of disorders of cervico-cranial region. The similarities of clinical presentation and pathogenetic mechanisms characteristic of skull base and neck anomalies, Meniere's syndrome and cervical vertigo are discussed. In conclusion, an assumption was made about the common origin of a whole group of the diseases associated with the cranio-cervical region.

A Holistic Approach to a Dizzy Patient: A Practical Update.

Dizziness is one of the most common symptoms encountered by physicians daily. It is divided into four categories: vertigo, disequilibrium, presyncope, and psychogenic dizziness. It is essential to distinguish these four symptoms because the causes, prognosis, and treatment differ. Vertigo constitutes a disease of the central or peripheral nervous system. Central origin vertigo may be a life-threatening situation and must be detected as soon as possible because it includes diseases such as stroke, hemorrhage, tumors, and multiple sclerosis. Peripheral origin vertigo includes benign diseases, which may be fully treatable such as vestibular migraine, benign paroxysmal positional vertigo, vestibular neuritis, Ménière's disease, and cervical vertigo. The HINTS (head impulse, nystagmus, test of skew) examination is essential to distinguish central from peripheral causes. A detailed history including the duration of vertigo (episodic or continuous), its trigger, and a clinical examination step by step following the appropriate protocol could help to make a definite and accurate diagnosis and treatment. Due to a lack of expertise in dizziness and inappropriate treatment, many patients are admitted to dizziness clinics with long-standing dizziness. A holistic treatment combining medications, vestibular rehabilitation, physiotherapy, and psychotherapy should be initiated to improve the quality of life of these patients. So, this review aims to recommend a clinical protocol for approaching a dizzy patient with vertigo and to present in detail the epidemiology, pathophysiology, symptoms, diagnosis, and contemporary treatments of all causes of vertigo.

[Micro-needle knife in treatment of cervical vertigo and its effect on vertebral artery hemodynamics].

OBJECTIVE: To compare the effect of micro-needle knife therapy and betahistine mesilate tablets in the treatment of cervical vertigo (CV) and the influence on the mean blood flow velocity (Vm) of vertebral artery. METHODS: A total of 200 patients with CV were randomly divided into a micro-needle knife group (100 cases, 5 cases dropped off) and a medication group (100 cases, 3 cases dropped off). In the micro-needle knife group, micro-needle knife was performed on the suboccipital triangle of the atlantoaxial segment of the posterior neck, once every other day, for a total of 7-time treatment. The medication group received oral betahistine mesilate tablets, 6 mg each time, three times a day, for 14 consecutive days. The dizziness handicap inventory (DHI) scores of the two groups were observed before treatment, after treatment and during follow-up 3 months after treatment; the Vm of vertebral artery was compared between the two groups before and after treatment, and the clinical effect was evaluated during follow-up. RESULTS: After treatment and during follow-up, the DHI scores of the two groups were lower than those before treatment (P<0.001), and those in the micro-needle knife group were lower than the medication group (P<0.001). After treatment, the Vm of bilateral vertebral arteries in both groups was higher than that before treatment (P<0.05), and that in the micro-needle knife group was higher than the medication group (P<0.05). The total effective rate of the micro-needle knife group was 96.8% (92/95), which was higher than 67.0% (65/97) of the medication group (P<0.001). CONCLUSION: Micro-needle knife therapy can improve vertigo symptoms and balance dysfunction, increase the mean blood flow velocity of vertebral artery in CV patients, and its clinical efficacy is better than oral betahistine mesilate tablets.

[Correlation between cervical vertigo and vestibular function evaluated by vestibular evoked myogenic potentials].

OBJECTIVE: To analyze the relationship between cervical vertigo and vestibular function evaluated by vestibular evoked myogenic potentials(VEMPs) and analyze the correlations between cervical vertigo and vestibular dysfunction, discuss the related factors of cervical vertigo and guide the clinical treatment of patients with cervical vertigo. METHODS: A total of 75 patients with cervical vertigo as the main complaint in the outpatient clinic of the Second Hospital of Shanxi Medical University from August 2019 to July 2020 were set as the diseased group, and 60 patients without cervical and vestibular related diseases in the hospital were selected to set as non-diseased group. The age of diseased group was 12 to 70 years with an average of (46.40±10.91) years, including 25 males and 50 females;and the age of non-diseased group was 22 to 60 years with an average of(43.78±7.75) years, including 19 males and 51 females. VEMPs were performed in the two groups. The data of VEMPs were collected and the results were compared and analyzed. The patients with abnormal cervical myogenic vestibular evoked myogenic potential (cVEMP) were divided into light, moderate and severe groups. The correlation between VEMPs and cervical vertigo and its severity were analyzed by statistical method. RESULTS: (1)The severity of cervical vertigo in diseased group:33 cases of mild, 34 cases of moderate, 8 cases of severe; cVEMP examination:62 cases were positive and 13 cases were negative, including 13 cases of mild, 33 cases of moderate, 16 cases of severe. The cVEMP of non-diseased group:4 cases were positive and 56 cases were negative.(2) The level of cVEMP in diseased group was higher than that in non-diseased group (P<0.001). It can be considered that there was a correlation between cervical vertigo and vestibular function.(3)The correlation between the level of cVEMP and the level of cervical vertigo in diseased group was analyzed. The Spearman rank sum test was used, and the correlation coefficient was 0.687, which was statistically significant (P<0.05). And it can be considered that the two indicators have a high degree of correlation. CONCLUSION: It is feasible to evaluate the relationship between cervical vertigo and vestibular function by VEMPs. For patients with cervical vertigo, the higher the severity, the greater the positive rate of VEMPs, which indicates that it has a greater impact on vestibular function. The treatment of patients with cervical vertigo should be the combination of cervical rehabilitation and vestibular function.

Effects of traction therapy on atlantoaxial joint dislocation-induced cervical vertigo

Cervical vertigo is a common complication of atlantoaxial joint dislocation. However, there is no consensus on the effects of different therapies on the recovery of the patients suffering cervical vertigo. The objective of this randomized controlled trial was to investigate the effect of traction therapy on reducing cervical vertigo induced by atlantoaxial joint dislocation. A total of 96 patients were randomized to receive traction therapy or traditional therapy for two weeks. The overall clinical efficacy was measured based on the 30-point cervical vertigo symptom and function evaluation form. The therapeutic effects were also evaluated based on lateral atlantodental space (LADS), vertigo scale, neck and shoulder pain scale, headache scale, daily life and work scale, psychosocial adaptation scale, and quality of life. Compared with the traditional therapy group, the traction group demonstrated markedly higher overall clinical efficacy (P=0.038). Both the traction therapy group and the traditional therapy group showed significant decrease in LADS (P<0.001), but the traction therapy group had a greater reduction of LAD compared with the traditional group (P<0.01). Traction therapy consistently led to significantly greater relief of cervical vertigo symptoms, including dizziness, neck and shoulder pain, headache, inconvenience in daily living and work activities, impaired psychosocial adaptation, while improving quality of life. The efficacy of traction therapy for cervical vertigo surpasses that of traditional therapy, suggesting that traction therapy is potentially more clinically useful in treating these patients.

Static balance and limits of stability in patients with cervical vertigo / 中国康复理论与实践

@#Objective To analyze the characteristics of static balance and limits of stability (LOS) in patients with cervical vertigo (CV). Methods From January, 2020 to August, 2021, 30 CV patients in our hospital (vertigo group) and 30 healthy people (control group) were selected and tested with PRO-KIN system, under the conditions of eyes open and closed. The standard deviation of the vertical and horizontal amplitude, the mean of vertical and horizontal sway velocities, the area of the movement, the length of the movement, and LOS at eight directions, The Romberg ratios of the area and the length were caculated. Results All the indicators of the static balance were higher under eyes closed than under eyes open in both groups (|Z| > 2.138, P < 0.05); whether under the eyes open or closed, the static balance indicators were higher in the vertigo group than in the control group (|Z| > 2.004, P < 0.05), except for the mean of horizontal sway velocities (|Z| < 1.026, P > 0.05). The LOS and total LOS completion percentage in the front (upper right, right above, upper left) were lower in the vertigo group than in the control group (|Z| > 2.240, P < 0.05). Conclusion The static balance abilities decrease for CV patients, and the balance control depends on visual compensation. The range of LOS reduces, means a higher risk of falling.

Correlation between cervical vertigo and vestibular function evaluated by vestibular evoked myogenic potentials / 中国骨伤

OBJECTIVE@#To analyze the relationship between cervical vertigo and vestibular function evaluated by vestibular evoked myogenic potentials(VEMPs) and analyze the correlations between cervical vertigo and vestibular dysfunction, discuss the related factors of cervical vertigo and guide the clinical treatment of patients with cervical vertigo.@*METHODS@#A total of 75 patients with cervical vertigo as the main complaint in the outpatient clinic of the Second Hospital of Shanxi Medical University from August 2019 to July 2020 were set as the diseased group, and 60 patients without cervical and vestibular related diseases in the hospital were selected to set as non-diseased group. The age of diseased group was 12 to 70 years with an average of (46.40±10.91) years, including 25 males and 50 females;and the age of non-diseased group was 22 to 60 years with an average of(43.78±7.75) years, including 19 males and 51 females. VEMPs were performed in the two groups. The data of VEMPs were collected and the results were compared and analyzed. The patients with abnormal cervical myogenic vestibular evoked myogenic potential (cVEMP) were divided into light, moderate and severe groups. The correlation between VEMPs and cervical vertigo and its severity were analyzed by statistical method.@*RESULTS@#(1)The severity of cervical vertigo in diseased group:33 cases of mild, 34 cases of moderate, 8 cases of severe; cVEMP examination:62 cases were positive and 13 cases were negative, including 13 cases of mild, 33 cases of moderate, 16 cases of severe. The cVEMP of non-diseased group:4 cases were positive and 56 cases were negative.(2) The level of cVEMP in diseased group was higher than that in non-diseased group (P<0.001). It can be considered that there was a correlation between cervical vertigo and vestibular function.(3)The correlation between the level of cVEMP and the level of cervical vertigo in diseased group was analyzed. The Spearman rank sum test was used, and the correlation coefficient was 0.687, which was statistically significant (P<0.05). And it can be considered that the two indicators have a high degree of correlation.@*CONCLUSION@#It is feasible to evaluate the relationship between cervical vertigo and vestibular function by VEMPs. For patients with cervical vertigo, the higher the severity, the greater the positive rate of VEMPs, which indicates that it has a greater impact on vestibular function. The treatment of patients with cervical vertigo should be the combination of cervical rehabilitation and vestibular function.

Positional Vertigo.

Positional vertigo is a complex symptom that may arise from several disorders. In this chapter, we define positional vertigo and provide a comprehensive review of the disorders in the differential diagnosis, including benign paroxysmal positional vertigo, central paroxysmal positional vertigo, cervical vertigo and vertebrobasilar insufficiency, and persistent postural perceptual dizziness.

Vertigo in Patients with Degenerative Cervical Myelopathy.

(1) Background: Cervical vertigo (CV) represents a controversial entity, with a prevalence ranging from reported high frequency to negation of CV existence. (2) Objectives: To assess the prevalence and cause of vertigo in patients with a manifest form of severe cervical spondylosis-degenerative cervical myelopathy (DCM) with special focus on CV. (3) Methods: The study included 38 DCM patients. The presence and character of vertigo were explored with a dedicated questionnaire. The cervical torsion test was used to verify the role of neck proprioceptors, and ultrasound examinations of vertebral arteries to assess the role of arteriosclerotic stenotic changes as hypothetical mechanisms of CV. All patients with vertigo underwent a detailed diagnostic work-up to investigate the cause of vertigo. (4) Results: Symptoms of vertigo were described by 18 patients (47%). Causes of vertigo included: orthostatic dizziness in eight (22%), hypertension in five (14%), benign paroxysmal positional vertigo in four (11%) and psychogenic dizziness in one patient (3%). No patient responded positively to the cervical torsion test or showed significant stenosis of vertebral arteries. (5) Conclusions: Despite the high prevalence of vertigo in patients with DCM, the aetiology in all cases could be attributed to causes outside cervical spine and related nerve structures, thus confirming the assumption that CV is over-diagnosed.

Histologic Observation and Significance of Sympathetic Nerve Fiber Distribution on Human Cervical Ligamentum Flavum.

OBJECTIVE: To study the distribution of sympathetic nerves of the ligamentum flavum (LF), confirm its existence by histological observation and nuclear magnetic resonance spectroscopy, and analyze the relationship between sympathetic nerve fibers and the biomechanical structure of the LF. METHODS: Randomly controlled scientific research selected 15 cases of posterior surgery in the affiliated hospital of Qingdao University from January 2013 to December 2019. The average age was 67.5 ± 14.5 years old, eight males and seven females. The LF specimens (completely separated fresh tissue) of different segments (C3-7 ) were taken during the operation. Two pages of LF specimens on the left and right sides of the same segment are randomly allocated by the pairing method for formalin fixation and cryopreservation in liquid nitrogen. LF specimens extracted from seven other adult cadaver specimens (average age at death of about 56.8 ± 4.0 years, three males and four females) were used as a control group; together with formalin- fixed specimens obtained during surgery, 3D slices were given layer by layer. The distribution of sympathetic nerves in different parts of the LF was analyzed by glyoxylic acid-induced biological monoamine fluorescent technique (SPG) and hematoxylin-eosin (HE) staining. Fifteen liquid nitrogen storage specimens were divided into the back of the LF and the spinal canal through frozen sections, and were analyzed by nuclear magnetic resonance spectroscopy-hydrogen spectrum (1 H -NMR) for neurotransmitters and neurometabolites. RESULTS: There were type C sympathetic nerve fibers in the LF, which were divided into linear shape (α) and wave shape (ß). Experimental group (χ2 = 1.705, P > 0.05) and control group (χ2 = 0.879, P > 0.05) can detect no difference in fluorescence units. Nerve fiber transmitter metabolites choline (Cho), creator (Cr), γ-aminobutyric acid (GABA) also indicate that the sympathetic nerve is present in the LF. LF sympathetic nerve fibers were mainly distributed in the proximal spinal canal surface, nerve fibers on the medial belt (area II) were fewer than the lateral belt (area I) (W = 210, P < 0.05). The 1 HNMR spectrum of LF spinal canal PG / Cho (t = 8.721, P < 0.05), GABA (t = 16.01, P < 0.05) value increased, lactic acid (Lac) / Cr (t = 4.213, P < 0.05), Cho / Cr (t = 2.402, P < 0.05) value decreased, indicating that nerve fibers are actively metabolized on the surface of the spinal canal, mainly distributed in tube surface. ßtype fibers were more often distributed around microvessels. A small amount of α type fibers went next to the vascular structures, while α type fibers and ß type fibers go cross within LF. Two patients with vertebral artery dissection had no recurrence of sympathetic symptoms within a total of 12 follow-ups 2 years after discharge. CONCLUSIONS: There are many sympathetic nerve fibers distributed on LF, and their distribution may be correlated with histological and mechanical characteristics of LF. It may also be the anatomical basis of cervical vertigo.

Evaluation of cervical spine muscles thickness in patients with cervical vertigo and healthy controls through ultrasonography.

[Purpose] Cervical vertigo as a common complaint is associated with some musculoskeletal disorders. However, to date, ultrasonographical parameters of cervical muscles in patients with cervical vertigo have not been investigated. This study was conducted to investigate size of cervical muscles in patients with cervical vertigo compared to healthy controls. [Participants and Methods] Thicknesses of cervical flexor and extensor muscles were evaluated through ultrasonography and results were compared between the patients and healthy controls by Independent Samples t-test or Mann-Whitney U nonparametric test. [Results] Results showed that, thickness of Longus Colli muscle was significantly different between the patients and healthy controls. [Conclusion] According to findings of the study, size of Longus Colli muscle is likely to be associated with etiology of cervical vertigo.

Tuina for cervical vertigo: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND AND PURPOSE: Cervical vertigo (CV), one of the most common causes of vertigo, makes patients feel dizzy, which seriously affects patients' lives. As a traditional Chinese bone-setting manipulation, Tuina is widely used to treat CV. This article aims to evaluate the effectiveness and safety of Tuina for CV. METHODS: Nine databases were searched. Methodological quality was evaluated with the Cochrane Collaboration's tool. Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was applied to determine confidence in the effect estimates. Stata 12.0 software was used to carry out the meta-analysis, and a trial sequential analysis (TSA) was performed with TSA 0.9. RESULTS: Nine randomized controlled trials (RCTs) were included. Low-quality evidence suggested that Tuina showed a significantly higher effectiveness rate compared to massage therapy (risk ratio (RR) = 1.11, 95% confidence intervals (CI): 1.05 to 1.17, p < 0.0001) and cervical traction (RR = 1.37, 95% CI: 1.09 to 1.72, p = 0.007; I2 = 0%, p = 0.826). Two trials reported that Tuina was better than acupuncture (RR = 1.40, 95% CI: 1.07 to 1.83) or betahistine mesilate (RR = 1.17, 95% CI: 0.99 to 1.37) based on an improved effectiveness rate. Low-quality evidence showed that Tuina was superior to massage therapy in improving scores on the evaluation scale for cervical vertigo (ESCV) (weighted mean differences (WMD) = 2.52, 95% CI: 1.11 to 3.94, p < 0.0001). Adverse events were tolerable. TSA revealed that an improved effectiveness rate was indicated. CONCLUSION: Tuina might improve the effectiveness rate and ESCV scores in patients with CV. However, the level of all the available evidence was low, and larger-scale and well-designed RCTs should be encouraged.

[A method to create a new rat model of combination of disease and syndrome with cervical vertigo hyperactivity of liver yang syndrome].

OBJECTIVE: To establish a simple and reliable model of cervical vertigo in rats with hyperactivity of liver-yang syndrome, and to establish a simple and feasible method for evaluating the degree of vertigo in animals. METHODS: SPF male SD rats (aged 8 weeks, weighing 280 to 320 g) were randomly divided into 4 groups (6 rats in each group). The model of cervical vertigo of hyperactivity of liver yang syndrome (joint modeling group) was established by combining local injection of lauromacrogol (hardener) and receiving fuzi decoction by gavage. The joint modeling group was compared with the hardener group, the fuzi decoction group and the blank control group. The vertigo degree of rats was measured by the time of passing through a glass tube (running time) before modeling, 2 weeks and 3 weeks after the established model. RESULTS: There was no statistical difference in the running time between control group and fuzi decoction group, between joint modeling group and hardener group. The running time in the hardener group and the joint modeling group was longer than that in the control group (P< 0.05), and was even longer than that in the fuzi decoction group (P<0.01). There was significant difference in running time after modeling compared with that before modeling (P<0.05); there was no significant difference in running time between 2 and 3 weeks after modeling (P>0.05). CONCLUSION: This method can effectively establish a rat model of cervical vertigo with hyperactivity of liver-yang syndrome, and the running time can reflect the degree of vertigo in rats to a certain extent. This experiment provides a simple and feasible animal model and detection method for research of cervical vertigo in the future.

A new treatment for cervical vertigo with botulinum toxin.

A new and unique treatment for cervical vertigo with botulinum toxin is presented for a woman who sustained neck trauma from being hit by a wave. A diagnosis of cervical vertigo and cervical dystonia was confirmed by history, physical exam, dystonia on EMG exam, and a negative test for benign paroxysmal positional vertigo. She experienced consistent resolution of her vertigo symptoms and pain after each treatment for a total of 5 treatments with botulinum toxin to the upper cervical muscles.This report appears to be the first to demonstrate the missing link between vertigo and cervical dystonia with pain. Chemodenervation was effective in treating cervical vertigo and is likely to have altered the cervical proprioceptive input by relaxing the overactive muscles and/or by decompression of cervical nerves.

Long-Term Clinical Outcomes of Percutaneous Cervical Nucleoplasty for Cervical Degenerative Diseases with Neck Pain and Cervical Vertigo.

BACKGROUND: Good short- and mid-term clinical efficacy of percutaneous cervical nucleoplasty (PCN) for cervical degenerative diseases (CDD) with neck pain has been reported. However, few studies have assessed its long-term influence in patients with both neck pain and cervical vertigo. This study aimed to evaluate the curative efficacy of PCN for CDD with neck pain and cervical vertigo with minimum of 6 years of follow-up. METHODS: Inpatients who underwent PCN for CDD with neck pain and cervical vertigo between April 2010 and March 2013 were enrolled. Clinical outcomes were assessed using the Cervical Vertigo Evaluation Scale (CVES); greater CVES scores reflected less impairment. Additional open surgeries were recorded. RESULTS: Among 40 patients, 100% completed the 1-year short-term and 3-year mid-term follow-up (FU); 85% completed the 6-year long-term FU. Clinical effective rates were 67.5%, 67.5%, and 52.94% at short-, mid-, and long-term FU, respectively. CVES scores were greater than the preoperative CVES scores at all FU timepoints (P < 0.01). However, the CVES score was lower at the final FU than at the 3-year FU (P < 0.05). The neck pain score significantly decreased over time and was lower than the cervical vertigo score at the final FU (P > 0.05). Reoperation rates were 1/40 (2.50%) and 3/34 (8.82%) at mid- and long-term FU, respectively. CONCLUSIONS: PCN in patients with CDD neck pain and cervical vertigo showed satisfactory clinical efficacy at short- and mid-term FU, and it was fair at long-term FU. Thus, PCN could be a complementary operation for CDD.

Shi-Style Cervical Mobilizations Versus Massage for Cervical Vertigo: A Multicenter, Randomized, Controlled Clinical Trial.

Objectives: Large sample and high-quality evidence to evaluate the preliminary safety of the mobilizations and massage for cervical vertigo are not yet available. Thus, the present study aimed to investigate the comparative effectiveness and preliminary safety of Shi-style cervical mobilizations (SCM) compared with traditional massage (TM) in cervical vertigo patients. Design: A prospective, multicenter, open-label, randomized, controlled clinical trial with a 1:1 allocation ratio. Settings: Five academic medical centers. Subjects: A total of 360 adult patients with a diagnosis of cervical vertigo. Interventions: The patients were randomly allocated to either an SCM (n = 180) or TM (n = 180) group. The patients were treated during six sessions over 2 weeks. The primary outcome was the Dizziness Handicap Inventory (DHI) total scale score, and secondary outcomes included the DHI subscales, Chinese version of the Short-Form 36 Health Survey (CSF-36), and adverse events (AEs). Outcomes were assessed in the short term at 2 weeks, 1 month, and 3 months, and in the intermediate term at 6 months after randomization. Results: Significant changes were observed from the baseline in the DHI total scale and subscales at 2 weeks and 1, 3, and 6 months in both groups (all p < 0.05). However, the differences between the two groups were not significant (all p > 0.05). Furthermore, we noted significant changes from the baseline in SF-36 scores at 2 weeks in both groups (all p < 0.05), whereas CSF-36 scores were not significantly higher in the SCM group (all p > 0.05) compared with the TM group. No serious AEs were reported in either of the two groups. Conclusions: No differences in outcomes were detected between the SCM and TM groups in terms of treatment of cervicogenic dizziness. Efficacy trials are required to determine whether the improvement observed for each treatment was causally related to the interventions.

Preoperative imaging differences of patients with cervical spondylosis with cervical vertigo indicate the prognosis after cervical total disc replacement.

OBJECTIVE: To evaluate the relationship between the preoperative imaging differences and prognosis in patients with cervical spondylosis with cervical vertigo who underwent total disc replacement (TDR). METHODS: This was a retrospective study of patients with cervical spondylosis with cervical vertigo treated with single-segment TDR. The severity of pre- and postoperative cervical vertigo was evaluated separately. Paired samples t-tests were used to compare the severity of the symptoms before and after surgery. Characteristics of plain films, computed tomography myelography and magnetic resonance imaging were compared between patients with different outcomes by analysis of variance and Fisher's exact tests. RESULTS: The severity of cervical vertigo was significantly different after single-segment TDR. Three groups with different treatment outcomes were not significantly different with regard to gender, age, type of the cervical spondylosis, follow-up time, segment of surgery, cervical curve, range of motion, T2WI high signal in the spinal cord, and location of compression. The type of compression was significantly different between the three groups. CONCLUSIONS: Cervical vertigo was improved in patients with cervical spondylosis through the TDR procedure. Those in whom a herniated disc was the main source of compression may have a better prognosis following TDR.

A method to create a new rat model of combination of disease and syndrome with cervical vertigo hyperactivity of liver yang syndrome / 中国骨伤

OBJECTIVE@#To establish a simple and reliable model of cervical vertigo in rats with hyperactivity of liver-yang syndrome, and to establish a simple and feasible method for evaluating the degree of vertigo in animals.@*METHODS@#SPF male SD rats (aged 8 weeks, weighing 280 to 320 g) were randomly divided into 4 groups (6 rats in each group). The model of cervical vertigo of hyperactivity of liver yang syndrome (joint modeling group) was established by combining local injection of lauromacrogol (hardener) and receiving decoction by gavage. The joint modeling group was compared with the hardener group, the decoction group and the blank control group. The vertigo degree of rats was measured by the time of passing through a glass tube (running time) before modeling, 2 weeks and 3 weeks after the established model.@*RESULTS@#There was no statistical difference in the running time between control group and decoction group, between joint modeling group and hardener group. The running time in the hardener group and the joint modeling group was longer than that in the control group (0.05).@*CONCLUSION@#This method can effectively establish a rat model of cervical vertigo with hyperactivity of liver-yang syndrome, and the running time can reflect the degree of vertigo in rats to a certain extent. This experiment provides a simple and feasible animal model and detection method for research of cervical vertigo in the future.