Different views are there like kinking of vertebral artery by osteophytes, propriceptive loss from facet joints etc. I need to know the correct explanation.
Vertigo in patient with cervical spondylosis, may result when osteophytes imping on the vertebral artery causing vertebrobasilar ischemia.
I agree with Dr. Parmar and Dr. Khan. However, the spondylosis as a source of vertigo incidents should be precisely diagnosed (type of vertigo, trigger moment, imaging diagnostics, extra- and intracranial Dopler sonography of vertebral arteries, angiography, etc.). I have the impression that some vertigo syndromes are poorly understood and insufficiently studied by the otoneurologists. That is why they very often refer similar insufficiently diagnosed patients to neurosurgeons or spinal surgeons with the simple explanation: "cervical osteophytes" as the reason for the complaints. On the contrary, the practice shows that this is not always adequately substantiated.
Cervical afferents modulate the activity within the vestibular nuclei (cervicovestibular reflexes). It may be that disorders affecting the joints and joint capsules in neck disease cause incorrect input in this situation leading to a sense of disequilibrium. This is in effect a disorder of proprioception.
VBI is rather different and, as discussed above, relates to disorders in posterior cerebral circulation caused by vascular impingement during movement.
Yes, I agree with Dr Simon Browning.
Proprioceptive influence on postural balance does exist. The symptoms are quite different from VBI.
We are now working with these patients with cervical pain and dizziness. Tey have normal vascular image and trigger points localized on cervical muscles. Their principal symptons are unsteadiness and disequilibrium.
The use of electrical stimulation and therapeutic manipulation improves not only the pain, but the dizziness too, It is statistically proven by posturography and questionnaires.
i think that we have to rule out vertebrobasilar insufficiency by performing MRA on the vertebrobasilar system in addition to MRI on the cervical spines