Effect of Anterior Cervical Discectomy and Fusion on Patients with Atypical Symptoms Related to Cervical Spondylosis

J Neurol Surg A Cent Eur Neurosurg. 2016 Sep;77(5):395-9. doi: 10.1055/s-0036-1582015. Epub 2016 May 11.

Abstract

Background A considerable number of patients with cervical spondylosis complain about one or multiple atypical symptoms such as vertigo, palpitations, headache, blurred vision, hypomnesia, and/or nausea. It remains unclear whether surgical intervention for cervical spondylosis can also effectively alleviate those symptoms. The current study was performed to see if anterior cervical diskectomy and fusion (ACDF) offers such an extra benefit for patients with cervical spondylosis. Objective To investigate if patients who received ACDF for the treatment of cervical spondylotic myelopathy and/or radiculopathy can also achieve alleviation of certain atypical symptoms associated with cervical spondylosis after the surgery in the long run. Methods Sixty-seven patients who underwent ACDF for the treatment of cervical spondylotic myelopathy and/or radiculopathy were involved in this study. All these patients also complained about various associated atypical symptoms. They were followed up for 26 to 145 months after the surgery. Severity and frequency scores of the atypical symptoms before the surgery and at last follow-up were compared by paired t tests. Results Most patients reported significantly alleviated symptoms at the last follow-up compared with before the surgery. The severity of vertigo, headache, nausea, and palpitations were significantly alleviated at the last follow-up (with p values of p < 0.001, p = 0.001, p = 0.022, p = 0.004, respectively). There were no significant changes in the severity of tinnitus (p = 0.182), blurred vision (p = 0.260), and hypomnesia (p = 0.821). Conclusion ACDF can significantly alleviate vertigo, headache, nausea, and palpitations in most patients with cervical spondylotic myelopathy and/or radiculopathy, but it is not effective in alleviating symptoms such as tinnitus, blurred vision, and hypomnesia. It can be considered for alleviating atypical symptoms when other treatment options prove ineffective.

MeSH terms

  • Adult
  • Aged
  • Cervical Vertebrae / surgery*
  • Diskectomy / methods*
  • Female
  • Headache / etiology
  • Headache / surgery
  • Humans
  • Male
  • Middle Aged
  • Nausea / etiology
  • Nausea / surgery
  • Retrospective Studies
  • Spinal Fusion / methods*
  • Spondylosis / complications
  • Spondylosis / surgery*
  • Tinnitus / etiology
  • Tinnitus / surgery
  • Treatment Outcome
  • Vertigo / etiology
  • Vertigo / surgery
  • Vision Disorders / etiology
  • Vision Disorders / surgery