The Relationship between the Grade of Cervical Spondylosis and the Flow Volume of Vertebral Arteries
Aim: While the earliest symptom of cervical spondylosis is neck pain, a variety of symptoms arise with osteophytes pressuring the neurovascular structures. Our aim is to investigate the possible relationship between the cervical spondylosis grading and the total debit of the vertebral arteries (VA).
Method: 142 patients with vertebrobasilar system Doppler US and cervical MRI were included in the study. Doppler US was performed with the head in neutral position; The VA V2 segment was assessed in 1/3 section of the neck. After the arterial diameter and flow characteristics were determined, the debit was automatically calculated by the device. The grade(G) of spondylosis in cervical MR was determined by the criteria of osteophyte formation, intervertebral disc height and vertebral end-plate degeneration based on Kellgren et al.'s staging.
Findings: There was no statistically significant difference between the consecutive stages of G1, G2, G3, and G4 in terms of VA (Tukey HSD);but there is a significant difference between G1 and G3, between G1 and G4, and between G2 and G4. As the stage increases, the debit decreases significantly(p<0.01). When the cases were categorized as G0,1,2 mild spondylosis and G3-4 severe spondylosis, there was a significant difference between two groups (Independent sample T-test). The VA debit was significantly lower in severe spondylosis(p<0.01).
Result: We think that discal and osseous changes occurring in severe spondylosis, may have a negative impact on total VA debit. We recommend Doppler US examination for vertebrobasilar system especially when severe cervical spondylosis is detected.