EVALUATION OF THE RESULTS OF SURGICAL AND MEDICALTREATMENT IN 16 PATIENTS WITH VERTIGO SECONDARY TOCERVICAL SPONDYLOSIS

Background: In patients with cervical spondylosis, cord compression and impingement of cord vessels as well as the vertebral artery may be accompanied by vertigo. We evaluated improvement of vertigo in these patients after surgical and medical treatment.
Methods: In this prospective study we reviewed 16 patients with vertigo suspected of cervical spondylosis, admitted to our hospital between 1999 and 2004. Before orthopedic examination, other causes of vertigo related to the field of ENT and neurologic problems had been ruled out. Dynamic angiography and /or Doppler sonography were performed in patients during flexion and extension and rotation of the cervical spine. Operations such as laminectomy and foraminotomy and resection of osteophytes were performed in patients who did not improve by conservative treatment.
Results: There were ten males and six females, with a mean age of 62.5 years. Twelve patients had cervical canal stenosis, and four patients also had vertebral artery stenosis. In two patients angioplasty of the vertebral artery was performed. Operations were performed in twelve patients and conservative treatment was used in four patients. Surgical treatment gave good relief of symptoms and was satisfactory in eight patients and not satisfactory in four patients. Conservative treatment improved symptoms in one patient, and was not satisfactory in three patients (p <.05).
Conclusion: Vertigo occurs in patients with cervical spondylosis, especially in old patients with spondylosis. In most cases we had improvement of vertigo by surgical decompression of the cervical cord and arteries.

Keywords
Cervical spondylosis, Vertigo, Cord compression, Vertebrobasilar insufficiency, neurovascular decompression, Foraminotomy, Laminectomy.