Effect of Cervical Decompression on Atypical Symptoms Cervical Spondylosis-A Narrative Review and Meta-Analysis
Kanwaljeet Garg1, Ankita Aggarwal2
1Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
Background:
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.
Methods:
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.
Results:
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.
Conclusions:
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.
