Garg Kanwaljeet, Aggarwal Ankita
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
Department of Radiodiagnosis, VMMC and Safdarjung Hospital, New Delhi, India.
World Neurosurg. 2022 Jan;157:207-217.e1. doi: 10.1016/j.wneu.2021.09.110. Epub 2021 Oct 14.
Atypical symptoms of cervical spondylosis refer to symptoms other than the typical symptoms of cervical spondylosis and include headache, nausea, gastrointestinal discomfort, blurred vision, tinnitus, hypomnesia, and palpitations. The role of cervical decompression in mitigating atypical symptoms of cervical spondylosis is still unclear.
A comprehensive search of different databases was performed to retrieve articles that studied the effect of cervical decompression on associated atypical symptoms. The data were analyzed to obtain pooled improvement in the various atypical symptoms after cervical decompression.
Twenty-seven studies were included in the meta-analysis. Our analysis showed that cervical decompression was associated with significant improvement in Neck Disability Index-Headache Component (standardized mean difference [SMD], -0.84; 95% confidence interval [CI], -0.94 to -0.74; P < 0.0001), visual analog scale (SMD, -1.47; 95% CI, -1.73 to -1.21; P = 0.0004) and cervicogenic headache (odds ratio [OR], 0.19; 95% CI, 0.06-0.63; P = 0.01). Significant improvement was also observed in vertigo (OR, 0.27; 95% CI, 0.10-0.77; P = 0.02), tinnitus (OR, 0.54; 95% CI, 0.35-0.83; P = 0.02), and nausea (OR, 0.25; 95% CI, 0.13-0.47; P = 0.006) after cervical decompression. Nonsignificant improvement was noticed in the rates of blurred vision, hypomnesia, giddiness, gastrointestinal discomfort, palpitations, and hypertension.
Our analysis showed that cervicogenic headache, tinnitus, and nausea were significantly relieved after cervical decompression. There was no significant effect of cervical decompression on blurred vision, hypomnesia, giddiness gastrointestinal discomfort, palpitations, and hypertension.
颈椎病的非典型症状是指除颈椎病典型症状之外的症状，包括头痛、恶心、胃肠道不适、视力模糊、耳鸣、记忆力减退和心悸。颈椎减压对减轻颈椎病非典型症状的作用仍不明确。
对不同数据库进行全面检索，以获取研究颈椎减压对相关非典型症状影响的文章。对数据进行分析，以得出颈椎减压后各种非典型症状的综合改善情况。
荟萃分析纳入了27项研究。我们的分析表明，颈椎减压与颈部残疾指数-头痛分量表（标准化均数差[SMD]，-0.84；95%置信区间[CI]，-0.94至-0.74；P<0.0001）、视觉模拟量表（SMD，-1.47；95%CI，-1.73至-1.21；P=0.0004）和颈源性头痛（优势比[OR]，0.19；95%CI，0.06 - 0.63；P=0.01）的显著改善相关。颈椎减压后眩晕（OR，0.27；95%CI，0.10 - 0.77；P=0.02）、耳鸣（OR, 0.54；95%CI，0.35 - 0.83；P=0.02）和恶心（OR，0.25；95%CI，0.13 - 0.47；P=0.006）也有显著改善。视力模糊、记忆力减退、头晕、胃肠道不适、心悸和高血压的改善率无显著差异。
我们的分析表明，颈椎减压后颈源性头痛、耳鸣和恶心得到显著缓解。颈椎减压对视力模糊、记忆力减退、头晕、胃肠道不适、心悸和高血压没有显著影响。
