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Association of Cervical Spondylosis with Peripheral Vertigo: A Case-Control Study

Cervical Spondylosis

Goal of the Study?

In this study, 1 the researchers investigated the association of prior cervical spondylosis (CS) diagnosis with peripheral vertigo in Taiwanese patients.

Why are they doing this study?

CS is an age-related condition resulting from deterioration in the spine, with a prevalence rate of more than 50% among those over 40 years old. While not all patients will have clinical signs of disease, symptoms can range from tingling, numbness, pain in the neck or arms, stiffness, headaches, vertigo, and balance loss.  Peripheral vertigo is often observed with CS and is one of the most common reasons patients get medical care.

The authors state that despite the wide prevalence, to date, no population-based studies are looking at the association between CS and peripheral vertigo. 

What was done?

The researchers used a case-control study design, selecting cases of peripheral vertigo and matched controls. They used the data from the Taiwan Longitudinal Health Insurance Database 2005 (LHID2005), which consists of all registration riles and medical claims data for a stratified random sample of 2 million enrollees.

They identified all those ≥ 18 years old who had received a diagnosis of peripheral vertigo between January 1, 2010, and December 31, 2016, which totalled 2,570 patients. These were compared to a control group of 7,710 patients from the same dataset (with 3 controls per one case), matching based on patient demographics such as age, sex, income, geographic location and medical comorbidities associated with increased risk of vertigo. They excluded all patients less than 18 years old and those who had never been diagnosed with peripheral vertigo.

They then used a statistical program to estimate determine the relationship between prior CS occurrence among peripheral vertigo patients versus controls. 

What did they find?

Overall, the researchers found that CS is associated with peripheral vertigo, particularly with those patients aged 45 to 64. This association is consistent with other research and may be caused by a range of issues, including cervical instability, inflammatory cytokine stimulation, and more.  They also found that CS with myelopathy (an injury to the spinal cord due to severe compression) is not associated with peripheral vertigo. 

They did not find any significant differences based on demographics. In particular, they did not find that patients over 64 years of age with CS had a higher risk of peripheral vertigo.

Limitations?

There are a few limitations outline by the authors. First, they state that claims data may not be as precise as information based on a clinical examination, resulting in some misclassification between types of vertigo. Second, there is a lack of data on potential confounding variables such as family history, lifestyle, etc. Finally, the vast majority of the study population are Han Chinese, and therefore the results may not be generalizable to other racial and ethnic groups. 

Cervical Spondylosis

Cervical model

Why do these findings matter?

As peripheral vertigo often occurs with CS, it is important to understand the relationship between the two conditions better to diagnose better and treat patients.  

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