Effect of percutaneous cervical nucleoplasty for treatment of cervicogenic vertigo and its influence on hemodynamics of vertebral artery
Objective To evaluate the clinical effect of percutaneous cervical nucleoplasty(PCN)in the treatment of cervico-genic vertigo and its influence on the hemodynamics of vertebral arteries,and to investigate the possible pathogenesis of cervico-genic vertigo.Methods Medical records of 66 patients with cervicogenic vertigo diagnosed and treated from August 2018 to August 2021 were retrospectively analyzed.Forty-three patients received PCN surgery and were included in the surgical group,while 23 patients received non-surgical treatment and were included in the non-surgical group.The visual analogue scale(VAS)for neck pain,sympathetic symptom score,neck disability index(NDI)after treatment as well as vertebral artery hemody-namics parameters at 12 months after treatment were compared between the two groups.Results In the surgical group,2 pa-tients underwent anterior cervical discectomy and fusion due to unsatisfactory results.In the non-surgical group,4 patients un-derwent PCN surgery and 1 patient underwent anterior cervical discectomy and fusion due to inability to tolerate vertigo symp-toms.In the surgical group,4 cases had ecchymosis at the operation site,and 2 cases complained of hoarseness,and recovered completely in the second week after operation.The remaining patients had no related complications.The neck pain VAS score,sympathetic symptom score,and NDI index in the surgical group were lower than those in the non-surgical group at 1,3,6,and 12 months after treatment.The blood flow velocity and blood flow volume of the left and right vertebral arteries in the surgical group were higher than those in the non-surgical group at 12 months after treatment,and the difference was statistically signifi-cant(P＜0.05).The total increase in bilateral vertebral artery blood flow volume at 12 months after treatment in the surgical group was positively correlated with the decrease in sympathetic symptom score(r=0.679,P＜0.001).Conclusion Percutane-ous cervical nucleoplasty has a satisfactory effect in the treatment of cervicogenic vertigo and is superior to non-surgical treat-ment in improving clinical symptoms.This procedure can increase the blood flow volume of bilateral vertebral arteries,and the total increase of blood flow volume is positively correlated with the decrease of sympathetic symptom score,suggesting that the change of vertebral artery blood flow volume plays an important role in the pathogenesis of cervicogenic vertigo.
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