The Clinical Research Of Reconstructing Stability By Anterior Cervical Operation In The Treatment Of Cervical Vertigo

【Objective】To explore the etiology and mechanism of cervical vertigo, to study the effect and mechanism of reconstruction and stability of anterior cervical surgery curing cervical vertigo, and to provide valuable reference for the diagnosis and treatment of cervical vertigo.【Methods】A total of 36 cervical spondylosis operated patients with cervical vertigo of Orthopedics 1 in Fujian Provincal Hospital were followed up in January 2007 to December 2009 by the means of telephone, outpatient appointment, and so on and were reviewed the case history and imaging data. All of the patients had giddiness or head giddy, and with symptoms such as neck and shoulder pain, headache, numbness in the hands, limb weakness, nausea, tinnitus, blurred vision, dry eye at the same time. All patients were excluded related disease by medicine, ophthalmology and otorhinolaryngology, etc, before admission to hospital and had poor curative effect of conservative treatment above 1 years.All were examined by C-Spine PA & LAT, C-Spine Dual Oblique, C-Spine Lordotic Kyphotic Position and cervical MRI and were judged cervical stability through the cervical instability criteria.All patients were done reconstruction and stability of anterior cervical surgery, analyzed by comparing with imaging data and the improvement of clinical symptoms preoperative and postoperative one week, 3 months and the last followed-up time, and evaluated the operative effect through "cervical vertigo symptomatic and functional evaluation method" further.【Results】All patients were followed up average 13 months (6 to 36 months).Preoperative cervical instability and intervertebral disc degeneration mainly happen in C4～5, then in C5～6. Postoperative imaging data showed that bone graft of surgery had good fusion and that normal physiological curvature of cervical vertebra get good reconstruction.Excellent rate of postoperative dizziness improvement was 88.9%: among the patients ,15 cases for optimal (41.7%), 17 cases for good (47.2%), 4 cases for medium(11.1%) . All patients improved the symptom of cervical vertebra disease different degree . The postoperative cervical vertigo symptomatic and functional evaluation score of patients were improved obviously comparing with preoperative score ,from the preoperative (12.47±2.65) points to the postoperative (24.08±2.23) points, with a statistical significance (P<0.05). There is no significant difference between different age groups,different course of the disease duration and operative efficacy,It can not explain the longer the duration or older the worse the treatment effects.【Conclusion】Reconstruction and stability of anterior cervical surgery has apparent therapeutic action to cervical vertigo. The instability of cervical vertebra and cervical intervertebral disc degeneration may be important factors in the pathogenesis of cervical vertigo.The improvement of postoperative symptoms such as vertigo may be related to removing these pathological factors which cause cervical sympathetic nerve to excite. Age and course are not the main factor influencing surgical curative effect.