الفهرس | Only 14 pages are availabe for public view |
Abstract Cervicogenic vertigo is defined as a sensation of rotation resulting from an alteration of the neck proprioceptive afferents of the upper cervical spine, as a consequence of their association with the vestibular nucleus, patients frequently experience a sensation of rotation or falling when they turn or flex and extend their head. (Biemond and De Jong.,1969). We did this systematic review study to evaluate the relation between cervical spine diseases and vertigo and how to manage it. The study was conducted to review the English language literature in order to identify evidence that fulfilled inclusion criteria. The search demonstrated the lack of good quality studies and reviews on the selected topic. Out of about 75 articles we identified only 5 randomized controlled studies that reported on diagnosis and management of cervicogenic vertigo and fulfilled the previous inclusion criteria. The first one (Karlberg et al.,1996) is a prospective, randomized controlled trial which ensure that physiotherapy improved but did not normalize the patients’ postural performance. The drawbacks of this article: the study and control groups had the same intervention,though the control group received the intervention after a certain delay. The second study (Reid et al.,2008) is a randomized controlled trial which found that SNAGs were a safe and effective manual therapy technique for the treatment of cervicogenic dizziness. The drawbacks of this article: there was no comparison between different interventions it was only pre and post treatment for the same intervention, and the primary outcome was subjective. The third study (Malmstrom et al.,2007) is a randomized controlled trial found that physiotherapy reduces neck pain as well as dizziness.More than half of the patients are improved after two years,but some patients need a maintenance strategy. The drawbacks of this article: the study and control groups had the same intervention,though the control group received the intervention after a certain delay. The fourth study (Hansson et al.,2006) is a randomized controlled trial found that vestibular rehabilitation for patients with whiplash-associated disorder can decrease self-perceived handicap and increase postural control. The drawbacks of this article:The control group was only delayed treatment group (i.e the control group only received the same intervention after a delay). The fifth study (Tjell and Rosenhall.,1998) is a prospective randomized controlled trial found that the SPNT test useful for diagnosing cervical dizziness ,at least in patients with WAD having symptoms of dizziness,because it has a high sensitivity and specificity. Since it was a single randomized controlled study reported on a specific test for diagnosing cervical dizziness, a meta-analysis could not be performed. Data available indicate the need for more randomized controlled and comparative trials to determine more accurately the best management for cervicogenic vertigo. |