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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2022; 41(04): e311-e315
DOI: 10.1055/s-0042-1749369
Original Article

Multi-Level Cervical Disc Degeneration and Vertigo

Degeneração do disco cervical em múltiplos níveis e vertigem
Serdar Ercan 
1   Department of Neurosurgery, School of Medicine, Atilim University, Ankara, Turkey
,
Murat Baloglu 
2   Department of Neurosurgery, Eskisehir City Hospital, Eskisehir, Turkey
› Author Affiliations Funding Statement The authors declare that they have received no funding regarding the performance of the present research.
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Abstract

Objective While complaints of pain, loss of strength, and numbness radiating to the neck and arm are common in patients due to cervical disc degeneration, vertigo is a rare symptom. The articles previously published on the subject focus on single-level disk degeneration and its correlation with vertigo. However, in the case of multilevel cervical discopathy, its effect on the severity of vertigo and its response to surgical treatment has not been clarified. Therefore, the objective of the present study is to shed light on the topic.

Methods Patients with vertigo complaints in whom all known etiological causes of vertigo had been excluded, but with cervical disc degeneration, were included in the study. The scores on the Visual Analog Scale (VAS) and Cervical Vertigo Evaluation Scale (CVES) were analyzed in terms of numbers of discopathy, spine levels, and differences regarding the preoperative and postoperative status.

Results A total of 24 patients (14 with single-level and 10 with multi-level disc degeneration) underwent anterior cervical discectomy. The preoperative CVES score was significantly decreased after surgery. Multi-level disc degeneration causes fewer vertigo symptoms than the single-level kind. No significant correlation between the severity of pain and vertigo was observed.

Conclusion Multi-level disc degeneration causes fewer vertigo symptoms. These symptoms decreased after anterior cervical discectomy in cases of single-level disk herniation at upper segments. The surgical intervention could be a favorable choice of treatment. However, the mechanism and treatment approach to cervical vertigo is still a controversial issue.

Resumo

Objetivo Embora as queixas de dor, perda de força e dormência com irradiação para o pescoço e braço sejam comuns em pacientes devido à degeneração do disco cervical, a vertigem é um sintoma raro. Os artigos publicados anteriormente se concentram na degeneração do disco de nível único e na sua correlação com a vertigem. No entanto, no caso da discopatia cervical em múltiplos níveis, seu efeito sobre a gravidade da vertigem e sua resposta ao tratamento cirúrgico não foi esclarecido. Portanto, o objetivo do presente estudo foi lançar luz sobre essa questão.

Métodos Foram incluídos no estudo pacientes com queixa de vertigem nos quais foram excluídas todas as causas etiológicas conhecidas de vertigem, mas que apresentavam degeneração discal cervical. As pontuações na Escala Visual Analógica (EVA) e na Escala de Avaliação da Vertigem Cervical (Cervical Vertigo Evaluation Scale, CVES, em inglês) foram analisadas em termos dos números de discopatia, dos níveis da coluna, e das diferenças entre o estado pré e pós-operatório.

Resultados A todo, 24 pacientes (14 com degeneração discal de nível único e 10 com degeneração em múltiplos níveis) foram submetidos a discectomia cervical anterior. A pontuação pré-operatória no CVES sofreu redução significativa após a cirurgia. A degeneração do disco em múltiplos níveis provoca menos sintomas de vertigem do que a de nível único. Não se observou correlação significativa entre a gravidade da dor e a vertigem.

Conclusão A degeneração discal em múltiplos níveis provoca menos sintomas de vertigem. Os sintomas de vertigem diminuíram após a de discectomia cervical anterior em hérnia de disco de nível único nos segmentos superiores. A intervenção cirúrgica pode ser uma escolha favorável no tratamento. No entanto, o mecanismo e a abordagem do tratamento da vertigem cervical ainda é uma questão controversa.

Keywords

vertigo - dizziness - cervical - disc degeneration

Palavras-chave

vertigem - tontura - cervical - degeneração discal

Ethical Publication Statement

We confirm that we have read the Journal's position on issues involving ethical publication, and declare that the present report is consistent with those guidelines.


Authors' Contributions

Serdar Ercan and Murat Baloglu: collection and analysis of data, and writing if the manuscript.




Publication History

Received: 21 March 2022

Accepted: 25 April 2022

Article published online:
07 July 2022

© 2022. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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