Cervical intervertebral disc degeneration and dizziness

Clinical studies have found that patients withcervical degenerative disease are usually accompanied by dizziness.Anterior cervical surgery can eliminate not only chronic neck pain,cervical radiculopathy or myelopathy,but also dizziness.Immunohistochemical studies show that a large number of mechanoreceptors,especially Ruffini corpuscles,are present in degenerated cervical discs.The available evidence suggests a key role of Ruffini corpuscles in the pathogenesis of dizziness caused by cervical degenerative disease(i.e.cervical discogenic dizziness).Disc degeneration is characterized by an elevation of inflammatory cytokines,which stimulates the mechanoreceptors in degenerated discs and results in peripheral sensitization.Abnormal cervical proprioceptive inputs from the mechanoreceptors are transmitted to the central nervous system,resulting in sensory mismatches with vestibular and visual information and leads to dizziness.In addition,neck pain caused by cervical disc degeneration can play a key role in cervical discogenic dizziness by increasing the sensitivity of muscle spindles.Like cervical discogenic pain,the diagnosis of cervical discogenic dizziness can be challenging and can be made only after other potential causes of dizziness have been ruled out.Conservative treatment is effective for the majority of patients.Existing basic and clinical studies have shown that cervical intervertebral disc degeneration can lead to dizziness.

CLINICAL COMPARISION OF THE TREATMENT OF CERVICAL PROLAPSE OF INTERVERTEBRAL DISC BY USING CAGE OR TITANIUM PLATE

Objective To compare the clinical effects of treating cervical prolapse of intervertebral disc by using Solis cage, titanium cage and autogenous iliac crest graft (AICG) combined with titanium plate. Methods 64 cases of cervical prolapse of intervertebral disc were analyzed retrospectively. All the patients were followed up for about one year. Group A is composed of 20 patients (30 intervertebral spaces) treated with microdiscectomy and Solis cage fusion; group B is composed of 21 patients(22 intervertebral spaces) treated with titanium cage and group C is involved of 23 patients(28 intervertebral spaces) which were dealt with AICG combined with titanium plate. The differences in the total X ray exposure time, time working on iliac bone, incidence of complications, fusion rate, incidence of JOA score recovery rate more than 50% and rehabilitation time of the three groups are analyzed. Results All indexes from group A and B were more satisfactory than those from group C (P<0.05). The statistic analysis results of the incidence of complications of cervical part, rehabilitation time in group A are 5.0±1.8, 5.1±1.2; and that is 14.3±2.6, 7.5 ±1.6 and 26.1±6.2, 8.6±2.3 in group B and group C respectively. There is significant difference between group A and group B on the incidence of complications of cervical part and rehabilitation time (P<0.05). Results of the incidence of JOA score recovery rate >50% in group A(95.8±3.2) was more satisfactory than that in group B(93.6±2.9), while there was no statistical difference between group A and group B (P>0.05). Conclusion The Solis cage is better in treating the cervical prolapse of intervertebral disc than other ways. Also, it makes the operation easier, rehabilitation time shorter, and it causes fewer complications.

Correlation between the Expression of Inflammatory Factors and the Degree of Intervertebral Disc Degeneration

Objective:To investigate the relationship between the expression of IL-6,IL-8,IL-15,IFN-a,TNF-a and TRPC6 in the disc tissue of patients with cervical disc degeneration.Methods:The expression levels of inflammatory factors IL-6,IL-8,IL-15,IFN-a,TNF-a and TRPC6 were analyzed by RTPCR,and the correlation between inflammatory factors and Pfirrmann grade and inflammatory factors was analyzed.Results:The mRNA expression levels of IL-6,IL-8,IL-15,TNF-a and TRPC6 were significantly higher in Pfirrmann grade IV-V than in Pfirrmann grade II-III(P<0.05),and IFN-a expression level in IV-V intervertebral disc samples was significantly lower than that in II-III discs(P<0.05);The mRNA expression levels of IL-6,IL-8,IL-15,TNF-a and TRPC6 were positively correlated with pfirmann grading(P<0.05),IFN-a was negatively correlated with pfirmann grading(P<0.05),IL-6,IL-8,IL-15,TNF-a and TRPC6 were positively correlated with each other(P<0.05),IFN-a was negatively correlated with IL-6,IL-8,IL-15,TNF-a and TRPC6(P<0.05).Conclusion:IL-6,IL-8,IL-15,IFN-a,TNF-a and TRPC6 are closely related to the degree of cervical disc degeneration.