World Journal of Clinical Cases
March 26, 2021; Vol. 9; No. 9; pp. 2146-2152
Tang-Hua Liu, Yan-Qing Liu, Bao-Gan Peng: This study cites 32 references.
This study represents a comprehensive literature search of PubMed and MEDLINE.
Dizziness, a ubiquitous complaint in clinical practice, often proves to be a perplexing puzzle for both patients and healthcare providers. Among the myriad causes of this disorienting symptom, cervicogenic dizziness emerges as a significant player, particularly in the realm of cervical degenerative disease. This exploration unveils key points from recent studies, shedding light on the intricate connection between cervical disc degeneration and the often-overlooked symptom of dizziness.
1. Cervicogenic Dizziness: A Common Culprit
- Dizziness, a frequent complaint encountered in clinical settings, finds an intriguing link to cervical degenerative disease.
- Cervicogenic dizziness, stemming from abnormal afferent activity in the neck, is identified as a prevalent etiology, especially in patients with chronic neck pain.
2. The Nexus of Neck Pain and Dizziness
- Chronic neck pain and dizziness stand as concomitant symptoms of cervical degenerative disease.
- Abnormal cervical proprioceptive inputs, arising from mechanoreceptors in degenerated discs, result in a sensory mismatch with vestibular and visual information, leading to dizziness.
3. Disc Degeneration: Inflammatory Catalyst
- Disc degeneration, characterized by the elevation of inflammatory cytokines, stimulates mechanoreceptors in degenerated discs, fostering peripheral sensitization.
- Immunohistochemical studies highlight the presence of Ruffini corpuscles in degenerated cervical discs, playing a pivotal role in the pathogenesis of cervical discogenic dizziness.
4. Abnormal Ingrowth and Neurological Consequences
- Abnormal ingrowth of nerve endings, particularly Ruffini corpuscles, correlates with abnormal nerve function.
- The increase of Ruffini corpuscles in patients with cervical spondylosis and dizziness underscores their involvement in the genesis of dizziness in cervical degenerative disease.
5. Prevalence of Dizziness in Cervical Degenerative Disease
- Cervical degenerative disease, the most common cervical spine disorder in humans, is frequently accompanied by dizziness.
- Studies suggest that 50%-65% of patients with cervical spondylosis experience dizziness.
6. Mechanisms of Dizziness in Cervical Disc Degeneration
- Evidence indicates that cervicogenic dizziness is a consequence of cervical disc degeneration, resulting in abnormal motion, mechanical stimulation, and erroneous signals.
- The strong connection between cervical dorsal roots and vestibular nuclei plays a pivotal role in the pathology of degenerative cervical discs and its association with dizziness.
7. Proprioceptive System in Focus
- Cervical intervertebral discs, a major source of neck pain, contribute significantly to the proprioceptive system of the cervical spine.
- Dysfunction or asymmetry in afferent inputs from mechanoreceptors can lead to imbalance or dizziness.
8. Diagnosis and Management
- Diagnosis of cervical discogenic pain and cervical discogenic dizziness necessitates ruling out other potential causes of dizziness.
- Conservative treatments, including manual therapy and physiotherapy, prove effective for the majority of patients.
- Chiropractic treatment showcases clinically relevant improvement for both neck pain with dizziness and neck pain without dizziness.
As we unravel the intricate connection between cervical degenerative disease and dizziness, it becomes evident that cervical discs, often silent in their degeneration, may orchestrate a symphony of symptoms, including dizziness. Understanding these complexities allows healthcare providers to adopt tailored interventions, emphasizing conservative treatments that prove efficacious for a significant number of patients. The nexus between neck pain and dizziness is unveiled, offering a pathway to improved diagnosis and management for those navigating the labyrinth of cervical degenerative disease.