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ORIGINAL ARTICLE
Year : 2020  |  Volume : 3  |  Issue : 1  |  Page : 3-7

Is Vertebral artery compression a cause of cervicogenic vertigo in cervical spondylosis patients? A color doppler ultrasound correlation study


1 Department of Otorhinolaryngology, Ear, Nose, Throat, All India Institute of Medical Sciences, Patna, Bihar, India
2 Department of Radiology, All India Institute of Medical Sciences, Patna, Bihar, India
3 Department of Orthopaedics, All India Institute of Medical Sciences, Patna, Bihar, India
4 Department of Community and Family Medicine, All India Institute of Medical Sciences, Patna, Bihar, India

Correspondence Address:
Kranti Bhavana
Department of Otorhinolaryngology, All India Institute of Medical Sciences, Phulwarisharif, Patna - 801 507, Bihar
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JODP.JODP_21_19

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Introduction: Pathophysiology of vertigo in patients having neck pain is not well understood, and many theories have been postulated. Cervical spondylitis is one of the most common causes of neck pain, and these are the group of patients who often complain of vertigo. The role of vascular flow alteration in these patients in causing vertigo is under investigation. We intended to study the vascular flow pattern in the vertebral circulation using color Doppler ultrasound in these patients and compare it with controls. Material and Methods: Fifteen cases and 11 controls were evaluated using color Doppler ultrasound. All these patients were evaluated in detail by the Ear, Nose, Throat and the orthopedics department. The statistical analysis was done by IBP SPSS version 22 software. Independent t-test was performed to compare the case and control groups. Results: The mean intimal thickness of common carotid artery of cases was significantly less than the controls (0.35 mm vs. 0.51 mm for the right common carotid artery and 0.38 mm vs. 0.54 mm for the left common carotid artery, P < 0.05). The diameter of the right vertebral artery (VA) in neutral and left rotation positions was less in cases than in controls, but the difference was not significant, whereas the diameter in the right rotation position was the same both in cases and controls. The blood flow velocity in the right VA was less in the cases than controls, but this difference was not statistically significant. The diameter of the left VA in all the three positions (neutral, right rotation, and left rotation) was less in cases than in controls, and this was statistically significant (P < 0.05) for neutral and left rotation positions. The blood flow velocity in the left VA was less in the cases than controls for all the three positions, but this difference was not statistically significant. Conclusion: 1. Our study demonstrates the role of vascular compromise in the VA circulation in patients suffering from cervical spondylosis and vertigo. Narrowing of VA was present in cases and that too on the left side. The cause behind left-sided predilection could not be ascertained with certainty. Since the difference in blood flow was not significant in cases and controls, a definitive correlation is possible only if the sample size is more and results are replicated 2. Mild relief in symptoms after physiotherapy in the form of transcutaneous nerve stimulation and interferential therapy also points toward a possible role of nerve irritation in causing vertigo in patients of cervical spondylosis. The causation seems to be multifactorial in nature.


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