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World J Clin Cases. Mar 26, 2021; 9(9): 2146-2152
Published online Mar 26, 2021. doi: 10.12998/wjcc.v9.i9.2146
Cervical intervertebral disc degeneration and dizziness
Tang-Hua Liu, Yan-Qing Liu, Bao-Gan Peng
Tang-Hua Liu, Department of Algology, The Third People's Hospital of Yibin, Yibin 644000, Sichuan Province, China
Yan-Qing Liu, Department of Algology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Bao-Gan Peng, Department of Orthopedics, The Third Medical Center, General Hospital of the Chinese People’s Liberation Army, Beijing 100039, China
Author contributions: Liu TH, Liu YQ, and Peng BG contributed to the writing and revising of the manuscript.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bao-Gan Peng, PhD, Professor, Surgeon, Department of Orthopedics, The Third Medical Center, General Hospital of the Chinese People’s Liberation Army, No. 69 Yongding Road, Haidian District, Beijing 100039, China. pengbaogan76611@163.com
Received: November 30, 2020
Peer-review started: November 30, 2020
First decision: March 8, 2021
Revised: March 12, 2021
Accepted: March 15, 2021
Article in press: March 15, 2021
Published online: March 26, 2021
Processing time: 114 Days and 10.2 Hours
Abstract

Clinical studies have found that patients withcervical degenerative disease are usually accompanied by dizziness. Anterior cervical surgery can eliminate not only chronic neck pain, cervical radiculopathy or myelopathy, but also dizziness. Immunohistochemical studies show that a large number of mechanoreceptors, especially Ruffini corpuscles, are present in degenerated cervical discs. The available evidence suggests a key role of Ruffini corpuscles in the pathogenesis of dizziness caused by cervical degenerative disease (i.e. cervical discogenic dizziness). Disc degeneration is characterized by an elevation of inflammatory cytokines, which stimulates the mechanoreceptors in degenerated discs and results in peripheral sensitization. Abnormal cervical proprioceptive inputs from the mechanoreceptors are transmitted to the central nervous system, resulting in sensory mismatches with vestibular and visual information and leads to dizziness. In addition, neck pain caused by cervical disc degeneration can play a key role in cervical discogenic dizziness by increasing the sensitivity of muscle spindles. Like cervical discogenic pain, the diagnosis of cervical discogenic dizziness can be challenging and can be made only after other potential causes of dizziness have been ruled out. Conservative treatment is effective for the majority of patients. Existing basic and clinical studies have shown that cervical intervertebral disc degeneration can lead to dizziness.

Keywords: Cervical intervertebral disc degeneration; Cervicogenic dizziness; Cervical discogenic dizziness; Cervical spondylosis; Neck pain; Mechanoreceptors

Core Tip: Cervical discogenic dizziness is an emerging and very attractive concept. Degenerative cervical discs are rich in Ruffini corpuscles and prone to inflammatory reactions resulting in dizziness that can be eliminated by intradiscal analgesic block. Based on basic and clinical findings, degenerated cervical discs can be thought as an important source of dizziness.