Abstract

Purpose

To investigate the effect of C3/4 disc degeneration on cervical spondylosis with dizziness (CSD) and to assess the curative effect of anterior cervical decompression and fusion (ACDF) in patients with CSD.

Method

Four hundred nineteen patients who underwent ACDF for treatment of myelopathy or radiculopathy were divided into dizziness and non-dizziness group. The visual analog scale (VAS) score and Japanese Orthopaedic Association (JOA) score were used to determine the intensity of dizziness and neurological symptoms, respectively. Cervical disc degeneration was evaluated using Miyazaki’s classification system. Some parameters were measured using cervical radiographs. The surgical effects on CSD were compared between surgery with and without C3/4 level. Multivariate logistic regression analysis was used to determine the risk factors for CSD.

Results

The pre-operative incidence of CSD was 33.9%. Women were more likely to develop dizziness than men (p < 0.05), CSD was significantly associated with C3/4 disc degeneration (69.7%, p < 0.001), and smokers were more subject to dizziness (p < 0.05). Regression analysis showed that female (OR = 1.611, p = 0.031), smoking (OR = 1.719, p = 0.032), Miyazaki grade of C3/4 ≥ IV (OR = 2.648, p < 0.001), and instability on C3/4 (OR = 1.672, p = 0.024) were risk factors for CSD. Treatment of CSD by ACDF involving C3/4 was more effective than not involving C3/4 (efficacy rate, 73.2% vs 51.7%, p < 0.05).

Conclusion

The CSD is a common clinical manifestation in elderly patients, especially patients with cervical spondylosis at the C3/4 level. Female, smoking, instability on C3/4, and C3/4 Miyazaki grade ≥ IV could be considered significant risk factors for CSD. CSD is more likely to be alleviated by ACDF involving C3/4.

中文翻译：

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C3 / 4椎间盘是否在头晕颈椎病中起作用？回顾性研究。

摘要

目的

目的探讨C3 / 4椎间盘退变对头晕颈椎病（CSD）的影响，并评估颈椎前路减压融合术（ACDF）对CSD患者的疗效。

方法

接受ACDF治疗脊髓病或神经根病的419例患者分为头晕和非头晕组。视觉模拟量表（VAS）评分和日本骨科协会（JOA）评分分别用于确定头晕的强度和神经系统症状。使用宫崎骏的分类系统评估颈椎间盘退变。使用宫颈X光片测量一些参数。比较有和无C3 / 4水平的手术对CSD的手术效果。多元logistic回归分析用于确定CSD的危险因素。

结果

术前CSD的发生率为33.9％。女性比男性更容易出现头晕（p  <0.05），CSD与C3 / 4椎间盘退变显着相关（69.7％，p  <0.001），吸烟者更容易出现头晕（p  <0.05）。回归分析显示女性（OR = 1.611，p  = 0.031），吸烟（OR = 1.719，p  = 0.032），宫崎级C3 / 4≥IV（OR = 2.648，p  <0.001），C3 / 4不稳定（OR = 1.672，p  = 0.024）是CSD的危险因素。ACDF介入C3 / 4治疗CSD比不介入C3 / 4更有效（有效率，分别为73.2％和51.7％，p  <0.05）。

结论

CSD是老年患者特别是C3 / 4级颈椎病患者的常见临床表现。女性，吸烟，C3 / 4不稳定和宫崎级C3 / 4≥IV可被认为是CSD的重要危险因素。涉及C3 / 4的ACDF更有可能缓解CSD。