Abstract
Cervical vertigo is a common complication of atlantoaxial joint dislocation. However, there is no consensus on the effects of different therapies on the recovery of the patients suffering cervical vertigo. The objective of this randomized controlled trial was to investigate the effect of traction therapy on reducing cervical vertigo induced by atlantoaxial joint dislocation. A total of 96 patients were randomized to receive traction therapy or traditional therapy for two weeks. The overall clinical efficacy was measured based on the 30-point cervical vertigo symptom and function evaluation form. The therapeutic effects were also evaluated based on lateral atlantodental space (LADS), vertigo scale, neck and shoulder pain scale, headache scale, daily life and work scale, psychosocial adaptation scale, and quality of life. Compared with the traditional therapy group, the traction group demonstrated markedly higher overall clinical efficacy (P=0.038). Both the traction therapy group and the traditional therapy group showed significant decrease in LADS (P<0.001), but the traction therapy group had a greater reduction of LAD compared with the traditional group (P<0.01). Traction therapy consistently led to significantly greater relief of cervical vertigo symptoms, including dizziness, neck and shoulder pain, headache, inconvenience in daily living and work activities, impaired psychosocial adaptation, while improving quality of life. The efficacy of traction therapy for cervical vertigo surpasses that of traditional therapy, suggesting that traction therapy is potentially more clinically useful in treating these patients.
Highlights
Atlantoaxial joint dislocation (AJD) is a common consequence of traumatic dislocation of the upper cervical spine or non-traumatic causes such as congenital causes, inflammation of the nasopharynx, and rheumatoid arthritis [1,2]
Manipulation of cervical bones and muscles is performed to bring the cervical spine into the neutral position using a rotational movement, which is commonly practiced by both western chiropractors and traditional Chinese herbalists [4]
The results provided by the study could shed light on the clinical benefit of traction therapy in reducing cervical vertigo as a treatment for AJD
Summary
Atlantoaxial joint dislocation (AJD) is a common consequence of traumatic dislocation of the upper cervical spine or non-traumatic causes such as congenital causes, inflammation of the nasopharynx, and rheumatoid arthritis [1,2]. Manipulation of cervical bones and muscles is performed to bring the cervical spine into the neutral position using a rotational movement, which is commonly practiced by both western chiropractors and traditional Chinese herbalists [4]. Cervical manipulation sometimes triggers a vertiginous attack that stems from decreased blood perfusion, leading to ischemic change in the cerebellum, inner ears, or brainstem [5–7]. Some patients with cervical vertigo experience illusion of movement, spinning or whirling, which lead to a certain level of disability and deteriorates quality of life [8]. Insufficient attention has been devoted to cervical vertigo in choosing the therapies for AJD. There is an urgent need to establish effective clinical treatment methods of AJD that minimizes cervical vertigo
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