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Yuan H, Ye F, Zhou Q, Feng X, Zheng L, You T, Cao R, Feng D. The Relationship between Atypical Symptoms of Degenerative Cervical Myelopathy and the Segments of Spinal Cord Compression: A Retrospective Observational Study. World Neurosurg 2022; 161:e154-e161. [PMID: 35092814 DOI: 10.1016/j.wneu.2022.01.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Patients with degenerative cervical myelopathy(DCM) often present with atypical symptoms such as vertigo, headache, palpitations, tinnitus, blurred vision, memory loss and abdominal discomfort. This study aims to investigate the relationship between atypical symptoms of DCM and the segments of spinal cord compression. METHODS 166 DCM patients with atypical symptoms admitted to our institution from 2019 to 2020 were divided into vertigo, headache, blurred vision, tinnitus and palpitations groups according to their atypical symptoms; while the typical group was 214 DCM patients with typical symptoms only. Differences in segments of compression were compared between each group. And the results of over one-year follow-up were further summarized for non-surgical and surgical treatment of DCM patients with atypical symptoms. RESULT The incidence of vertigo, headache, blurred vision, tinnitus and palpitations of all DCM patients was 37%, 18%, 15%, 11% and 11% respectively. Compared to the typical group, patients in the blurred vision and tinnitus group were older (P < 0.05) and the incidence of spinal cord compression at C3-5 in the vertigo group, C4-5 in the headache group and C6-7 in the palpitation group was higher (P < 0.05). The scores of vertigo, headache and palpitations decreased after surgical decompression (P < 0.05), whereas only vertigo and headache scores decreased after non-surgical treatment (P < 0.05). CONCLUSION Atypical symptoms were common in patients with DCM and the segments of spinal cord compression might be associated with specific atypical symptoms. Surgical treatment is effective in relieving some of the atypical symptoms.
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Affiliation(s)
- Hao Yuan
- Spinal Surgery Department, The Affiliated Hospital of Southwest Medical University, 646000, Luzhou, China
| | - Fei Ye
- Spinal Surgery Department, The Affiliated Hospital of Southwest Medical University, 646000, Luzhou, China
| | - Qinzhong Zhou
- Spinal Surgery Department, The Affiliated Hospital of Southwest Medical University, 646000, Luzhou, China
| | - Xiaolan Feng
- Department of Imaging, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan province, China
| | - Lipeng Zheng
- Spinal Surgery Department, The Affiliated Hospital of Southwest Medical University, 646000, Luzhou, China
| | - Ting You
- Spinal Surgery Department, The Affiliated Hospital of Southwest Medical University, 646000, Luzhou, China
| | - Renping Cao
- Spinal Surgery Department, The Affiliated Hospital of Southwest Medical University, 646000, Luzhou, China
| | - Daxiong Feng
- Spinal Surgery Department, The Affiliated Hospital of Southwest Medical University, 646000, Luzhou, China.
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Huang F, Zhao S, Dai L, Feng Z, Wu Z, Chen J, Guo R, Tian Q, Fan Z, Wu S. Tuina for cervical vertigo: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Clin Pract 2020; 39:101115. [PMID: 32379654 DOI: 10.1016/j.ctcp.2020.101115] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 02/01/2020] [Accepted: 02/01/2020] [Indexed: 10/25/2022]
Abstract
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.
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Affiliation(s)
- Fan Huang
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
| | - Siyi Zhao
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Lin Dai
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zitong Feng
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zhennan Wu
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Jia Chen
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Rusong Guo
- The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Qiang Tian
- The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zhiyong Fan
- The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
| | - Shan Wu
- The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
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Zheng S, Muheremu A, Sun Y, Tian W, Wu CA. Preoperative imaging differences of patients with cervical spondylosis with cervical vertigo indicate the prognosis after cervical total disc replacement. J Int Med Res 2019; 48:300060519877033. [PMID: 31640443 PMCID: PMC7607185 DOI: 10.1177/0300060519877033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
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.
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Affiliation(s)
- Shan Zheng
- Department of Spine Surgery, Beijing Jishuitan Hospital, Beijing, China
| | | | - Yuqing Sun
- Department of Spine Surgery, Beijing Jishuitan Hospital, Beijing, China
| | - Wei Tian
- Department of Spine Surgery, Beijing Jishuitan Hospital, Beijing, China
| | - Cheng-Ai Wu
- Department of Molecular Orthopaedics, Beijing Institute of Traumatology and Orthopaedics, Beijing, China
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Meng Z, Yu J, Luo C, Liu X, Jiang W, Yu L, Huang R. Anterior Cervical Spondylosis Surgical Interventions are Associated with Improved Lordosis and Neurological Outcomes at Latest Follow up: A Meta-analysis. Sci Rep 2017; 7:4407. [PMID: 28667278 PMCID: PMC5493671 DOI: 10.1038/s41598-017-04311-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 05/10/2017] [Indexed: 11/09/2022] Open
Abstract
Aim of this study was to evaluate the effect of cervical spondylosis surgery on cervical lordosis and to identify factors affecting the change by latest follow-up. Literature search was carried out in electronic databases and study selection followed a priori eligibility criteria. Random effects meta-analyses were performed to estimate effect size/s of change in lordosis after surgery (at latest follow-up) and metaregression analyses were performed to identify factors affecting this change. Nineteen studies (1845 patients; age 55.18 [95% CI: 54.78, 55.57] years; 60.99 [60.63, 61.36] % males; follow-up 25.59 [25.20, 25.99] months) were included. Whereas, corpectomy (4.06 [2.65, 5.46] degree; p < 0.00001) and discectomy (4.59 [2.07, 7.11] degree; p < 0.00001) were associated with increase, laminectomy (-1.87 [-8.40, 4.66] degree; p = 0.57) and laminoplasty (0.25 [-1.07, 1.56] degree; p = 0.711) were not associated with significant change in lordosis at latest follow-up. Change in Japanese Orthopedic Association (JOA)/modified JOA (mJOA) score at latest follow-up was also significantly (p = 0.0005) higher in anterior than in posterior surgery group. Change in lordosis at latest follow-up had significant positive relationship with follow-up duration but had significant inverse associations with age, male gender, and preoperative JOA/mJOA score, independently. In posterior surgery subjects, after adjusting for age and gender, preoperative JOA/mJOA score was significantly inversely related to change in lordosis.
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Affiliation(s)
- Zengdong Meng
- Department of Orthopaedics, First People's Hospital of YunNan Province, YunNan, P. R. China
| | - Jing Yu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, P. R. China
| | - Chong Luo
- Department of Orthopaedics, First People's Hospital of YunNan Province, YunNan, P. R. China
| | - Xia Liu
- Shanghai Key Laboratory of Forensic Medicine, Institute of Forensic Science, Ministry of Justice, Shanghai, P.R. China
| | - Wei Jiang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
| | - Lehua Yu
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
| | - Rongzhong Huang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China.
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